Docusign Envelope ID: E8685CC4-14C5-4BAB-801C-E16EEE98CF65 REGION{ EXHIBIT 4
- £0
Request for Vendor Contract Update
Pursuant to the terms of your awarded vendor contract, all vendors must notify and receive approval from Region 4/OMNIA Partners, Public Sector when there is an update in the contract. No request will be officially approved without the prior authorization of Region 4. Region 4 reserves the right to accept or reject any request. _
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rp ___________ hereby provides notice of the following update to (Vendor Nome}
Contract number: R240303 for -----------
SoftWare Solutions and Services on this date 1/20/2026
Contract Title
Instructions: Vendors must check all that may apply and shall provide supporting documentation. Place your initials next to each item to co firm that documents are indeed included. Request received without supporting documentation will be returned.
□ Authorized Distributors/Dealers
___ Addition
___ Deletion
___ Supporting Documentation
□ Products/Services
___ New Addition
___ Update Only
___ Supporting Documentation
□ Discontinued Products/Services
___ Supporting Documentation
D States/Territories
___ Supporting oJcumentation
□ Price Update
___ Supporting Documentation
□ Material Change
___ Assignment
___ Change in ownership (sale/purchase)
___ Bankruptcy
___ Acquisition
___ Merger
___ Supporting Documentation
� Other
_✓ __ Supporting Documentation
Notes: Vendor may include other notes regarding the contract update here: (attach another page if necessary). For material changes, indicate the name of the company of the awarded supplier and the official name of assigned or added company.
Ple ase see att ache d.
Submitted By: Benjamin Rader
Title: Contract Specialist
Version 9/19/2024
□ Approved Date __
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D Denied Date-----------
It�.� Region 4 ESC 1st Revie�