AMENDMENT NO. 1
TO AGREEMENT FOR CONTRACTOR SERVICES
Prudential Overall Supply
Employee Uniforms, Shop Towels and Logo Mat Services
This Amendment No. 1 to Agreement for Contractor Services is made and entered into as of 7/23/2024, by and between the City of Lake Elsinore, a municipal corporation (“City), and Prudential Overall Supply, a Corporation (“Contractor”).
RECITALS
A. The City and Contractor have entered into that certain Agreement for Contractor Services dated as of 7/11/2023, (the “Original Agreement”). Except as otherwise defined herein, all capitalized terms used herein shall have the meanings set forth for such terms in the Original Agreement.
B. The Original Agreement provided for compensation to Contractor in an amount of Twenty-One Thousand dollars ($21,000).
C. The Original Agreement had a term of commencing on July 1, 2023, and ending June 30, 2025. The City may, at its discretion, extend the term of this Agreement on a 12-month basis not to exceed 2 additional twelve (12) month renewal terms.
D. The parties now desire to amend and increase the payment for such services as set forth in this Amendment No. 1 for an annual amount not to exceed ($23,784).
NOW, THEREFORE, in consideration of the mutual covenants and conditions set forth herein, City and Contractor agree as follows:
1. Section 3, Compensation, of the Original Agreement is hereby amended to read in its entirety as follows:
Compensation to be paid to Contractor shall be in accordance with the fees set forth in Contractor ’s Proposal (Exhibit A-1), which is attached hereto and incorporated herein by reference. In no event shall Contractor ’s annual compensation exceed Twenty-Three Thousand Seven Hundred Eighty-Four ($23,784.00) without additional written authorization from the City Council.
2. Except for the changes specifically set forth herein, all other terms and conditions of the Original Agreement shall remain in full force and effect.
IN WITNESS WHEREOF, the parties have caused this Amendment No. 1 to be executed on the respective dates set forth below.
“CITY”
CITY OF LAKE ELSINORE, a municipal
corporation
“CONTRACTOR”
Prudential Overall Supply, a corporation
Docusign Envelope ID: 3DF18E70-EB6C-4ACB-ABED-F3983EABA259 City Manager
Date:
JP Landin
Date: __
ATTEST:
City Clerk
APPROVED AS TO FORM:
City Attorney
Assistant City Manager
Attachments: Exhibit A-1 – Contractor ’s Proposal
Docusign Envelope ID: 3DF18E70-EB6C-4ACB-ABED-F3983EABA259 7/27/2024 | 9:26 PM PDT
7/27/2024 | 11:03 PM PDT
EXHIBIT A-1
CONTRACTOR ’S PROPOSAL
[ATTACHED]
Docusign Envelope ID: 3DF18E70-EB6C-4ACB-ABED-F3983EABA259
INVOICE
RUBEN MORENO
6997 Jurupa Ave., Riverside, Ca 92504
23670777Invoice Number:
07/04/2024Invoice Date:
Customer Sales Rep:
Telephone Fax951-687-0440 951-354-8110
Plant's Location:
Remit Payment: PO BOX 11210, Santa Ana, CA 92711-1210
Deliver To: # Bill To: #40237407 3517225Charge
LAKE ELSINORE PUBLIC WORKS
521 NORTH LANGSTAFF
LAKE ELSINORE, CA 92530
LAKE ELSINORE PUBLIC WORKS
521 NORTH LANGSTAFF
LAKE ELSINORE, CA 92530
ATTENTION: ACCOUNTS PAYABLE
Unit
Charge
Wearer
Description
Mdse. Product Description Service Bill
Qty
Amount
69034 MAT 3X4 BLACK Rent 16.81 2.801
29034 MAT 3X4 BLACK MMP 1.17 0.584
2009792 18X18 PURPLE SHOP TOWEL Rent 14.80 0.074
49792 18X18 PURPLE SHOP TOWEL MMP 1.70 0.424
49985 22X44 WHITE BATH TOWEL Rent 1.32 0.329
19985 22X44 WHITE BATH TOWEL MMP 2.12 2.122
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26102 0.478GUSTAVO DELAT 1178442799 MENS GREY MIMIX WORK SHIRT Rent 4.55 0.414
11753311 DENIM COTTON WESTERN PANT Rent 5.49104 0.499RAMIRO DELGAD 778442799 MENS GREY MIMIX WORK SHIRT Rent 2.90 0.414
478442799 MENS GREY MIMIX WORK SHIRT Rent 1.66 0.414
11734416 CHARCOAL WORK PANT Rent 2.33106 0.212OSCAR VASQUE 11777508PA POLO SHIRT-100% POLYTRI BLACK Rent 4.09 0.372 11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26108 0.478ALFONSO MONT 578442799 MENS GREY MIMIX WORK SHIRT Rent 2.07 0.414
678442799 MENS GREY MIMIX WORK SHIRT Rent 2.48 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26109 0.478ALEX CANAS 1178442799 MENS GREY MIMIX WORK SHIRT Rent 4.55 0.414
11753311 DENIM COTTON WESTERN PANT Rent 5.49110 0.499HECTOR GONZA 5777508PA POLO SHIRT-100% POLYTRI BLACK Rent 1.86 0.372 11777508PA POLO SHIRT-100% POLYTRI BLACK Rent 4.09 0.372 11753311 DENIM COTTON WESTERN PANT Rent 5.49111 0.499MATT REED 11777508PA POLO SHIRT-100% POLYTRI BLACK Rent 4.09 0.372 11753311 DENIM COTTON WESTERN PANT Rent 5.49112 0.499LUIS CEJA 5777508PA POLO SHIRT-100% POLYTRI BLACK Rent 1.86 0.372 11777508PA POLO SHIRT-100% POLYTRI BLACK Rent 4.09 0.372 11734416 CHARCOAL WORK PANT Rent 2.33113 0.212DANIEL SAAVED 11753311 DENIM COTTON WESTERN PANT Rent 5.49 0.499
7777508PA POLO SHIRT-100% POLYTRI BLACK Rent 2.60 0.372 11777508PA POLO SHIRT-100% POLYTRI BLACK Rent 4.09 0.372 11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26114 0.478WILL YANG 1178442799 MENS GREY MIMIX WORK SHIRT Rent 4.55 0.414
11734416 CHARCOAL WORK PANT Rent 2.33117 0.212CHRIS ERICKSO 11777508PA POLO SHIRT-100% POLYTRI BLACK Rent 4.09 0.372 11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26118 0.478JUSTIN THOMPS This invoice is in accordance with your Service Rental Agreement. Please forward to your Accounts Payable Department.
Payment Terms 30 days from invoice date or upon receipt of monthly statement. Thank you for the opportunity to serve ! Docusign Envelope ID: 3DF18E70-EB6C-4ACB-ABED-F3983EABA259
INVOICE
RUBEN MORENO
6997 Jurupa Ave., Riverside, Ca 92504
23670777Invoice Number:
07/04/2024Invoice Date:
Customer Sales Rep:
Telephone Fax951-687-0440 951-354-8110
Plant's Location:
Remit Payment: PO BOX 11210, Santa Ana, CA 92711-1210
Deliver To: # Bill To: #40237407 3517225Charge
LAKE ELSINORE PUBLIC WORKS
521 NORTH LANGSTAFF
LAKE ELSINORE, CA 92530
LAKE ELSINORE PUBLIC WORKS
521 NORTH LANGSTAFF
LAKE ELSINORE, CA 92530
ATTENTION: ACCOUNTS PAYABLE
Unit
Charge
Wearer
Description
Mdse. Product Description Service Bill
Qty
Amount
1178442799 MENS GREY MIMIX WORK SHIRT Rent 4.55118 0.414JUSTIN THOMPS 5777508PA POLO SHIRT-100% POLYTRI BLACK Rent 1.86120 0.372JOSE FONSECA 11777508PA POLO SHIRT-100% POLYTRI BLACK Rent 4.09 0.372 11753311 DENIM COTTON WESTERN PANT Rent 5.49123 0.499DAVID CHAVEZ 878442799 MENS GREY MIMIX WORK SHIRT Rent 3.31 0.414
378442799 MENS GREY MIMIX WORK SHIRT Rent 1.24 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26124 0.478KYLE BELL 1178442799 MENS GREY MIMIX WORK SHIRT Rent 4.55 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26125 0.478LANDEN FINLEN 1178442799 MENS GREY MIMIX WORK SHIRT Rent 4.55 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26127 0.478TUA MASOLI 1178442799 MENS GREY MIMIX WORK SHIRT Rent 4.55 0.414
9733816 MEN'S CHARCOAL MIMIX PANT Rent 4.30128 0.478RICARDO GAMB 578442799 MENS GREY MIMIX WORK SHIRT Rent 2.07 0.414
678442799 MENS GREY MIMIX WORK SHIRT Rent 2.48 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26129 0.478CHRISTIAN KERR 173441699 CHARCOAL MENS SHORT Rent 0.21 0.212
1078442799 MENS GREY MIMIX WORK SHIRT Rent 4.14 0.414
178442799 MENS GREY MIMIX WORK SHIRT Rent 0.41 0.414
1784227 LT GRAY WORK SHIRT Rent 0.19130 0.191SIZING KIT 1784227 LT GRAY WORK SHIRT Rent 0.19 0.191
1784227 LT GRAY WORK SHIRT Rent 0.19 0.191
1784227 LT GRAY WORK SHIRT Rent 0.19 0.191
1784227 LT GRAY WORK SHIRT Rent 0.19 0.191
1784227 LT GRAY WORK SHIRT Rent 0.19 0.191
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26132 0.478PABLO RUBIO 578442799 MENS GREY MIMIX WORK SHIRT Rent 2.07 0.414
678442799 MENS GREY MIMIX WORK SHIRT Rent 2.48 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26134 0.478JOEL DE LEON 1178442799 MENS GREY MIMIX WORK SHIRT Rent 4.55 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26135 0.478LUIS RENTERIA 678442799 MENS GREY MIMIX WORK SHIRT Rent 2.48 0.414
578442799 MENS GREY MIMIX WORK SHIRT Rent 2.07 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26138 0.478MIGUEL VALDIVI 678442799 MENS GREY MIMIX WORK SHIRT Rent 2.48 0.414
This invoice is in accordance with your Service Rental Agreement. Please forward to your Accounts Payable Department.
Payment Terms 30 days from invoice date or upon receipt of monthly statement. Thank you for the opportunity to serve ! Docusign Envelope ID: 3DF18E70-EB6C-4ACB-ABED-F3983EABA259
INVOICE
RUBEN MORENO
6997 Jurupa Ave., Riverside, Ca 92504
23670777Invoice Number:
07/04/2024Invoice Date:
Customer Sales Rep:
Telephone Fax951-687-0440 951-354-8110
Plant's Location:
Remit Payment: PO BOX 11210, Santa Ana, CA 92711-1210
Deliver To: # Bill To: #40237407 3517225Charge
LAKE ELSINORE PUBLIC WORKS
521 NORTH LANGSTAFF
LAKE ELSINORE, CA 92530
LAKE ELSINORE PUBLIC WORKS
521 NORTH LANGSTAFF
LAKE ELSINORE, CA 92530
ATTENTION: ACCOUNTS PAYABLE
Unit
Charge
Wearer
Description
Mdse. Product Description Service Bill
Qty
Amount
578442799 MENS GREY MIMIX WORK SHIRT Rent 2.07138 0.414MIGUEL VALDIVI 11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26139 0.478ANGEL ACEVED 678442799 MENS GREY MIMIX WORK SHIRT Rent 2.48 0.414
578442799 MENS GREY MIMIX WORK SHIRT Rent 2.07 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26141 0.478CHRISTINA ALVA 1178442799 MENS GREY MIMIX WORK SHIRT Rent 4.55 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26143 0.478EDDIE HERRERA 1178442799 MENS GREY MIMIX WORK SHIRT Rent 4.55 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26144 0.478JOSEPH SELVAG 678442799 MENS GREY MIMIX WORK SHIRT Rent 2.48 0.414
578442799 MENS GREY MIMIX WORK SHIRT Rent 2.07 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26147 0.478DANE GRIPPO 1178442799 MENS GREY MIMIX WORK SHIRT Rent 4.55 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26148 0.478JULIAN PARRA 1178442799 MENS GREY MIMIX WORK SHIRT Rent 4.55 0.414
378442799 MENS GREY MIMIX WORK SHIRT Rent 1.24 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26149 0.478CHRIS LOPEZ 1178442799 MENS GREY MIMIX WORK SHIRT Rent 4.55 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26150 0.478JEREMY MEDWI 578442799 MENS GREY MIMIX WORK SHIRT Rent 2.07 0.414
678442799 MENS GREY MIMIX WORK SHIRT Rent 2.48 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26151 0.478KOBE CELIS 1178442799 MENS GREY MIMIX WORK SHIRT Rent 4.55 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26152 0.478HOUSTON OMAL 1178442799 MENS GREY MIMIX WORK SHIRT Rent 4.55 0.414
11733816 MEN'S CHARCOAL MIMIX PANT Rent 5.26153 0.478NEHEMIAH DAVI 578442799 MENS GREY MIMIX WORK SHIRT Rent 2.07 0.414
678442799 MENS GREY MIMIX WORK SHIRT Rent 2.48 0.414
- Budget Protection Program Protection Cov. 0.106 82.47778 9921BB AUTOMATIC SOAP DISPENSER BLACK Sales 0.0063.654
9937ALC ALCO-FOAM SANITIZER 900ML CASE Sales 0.0090.527 Delivery Charge 10.61
This invoice is in accordance with your Service Rental Agreement. Please forward to your Accounts Payable Department.
Payment Terms 30 days from invoice date or upon receipt of monthly statement. Thank you for the opportunity to serve ! Docusign Envelope ID: 3DF18E70-EB6C-4ACB-ABED-F3983EABA259
INVOICE
RUBEN MORENO
6997 Jurupa Ave., Riverside, Ca 92504
23670777Invoice Number:
07/04/2024Invoice Date:
Customer Sales Rep:
Telephone Fax951-687-0440 951-354-8110
Plant's Location:
Remit Payment: PO BOX 11210, Santa Ana, CA 92711-1210
Deliver To: # Bill To: #40237407 3517225Charge
LAKE ELSINORE PUBLIC WORKS
521 NORTH LANGSTAFF
LAKE ELSINORE, CA 92530
LAKE ELSINORE PUBLIC WORKS
521 NORTH LANGSTAFF
LAKE ELSINORE, CA 92530
ATTENTION: ACCOUNTS PAYABLE
Unit
Charge
Wearer
Description
Mdse. Product Description Service Bill
Qty
Amount
463.73Service Total
Sales Tax 0.00
463.73Invoice TOTAL
$
$
$
Signature Date:
Initials:
Signature Time:
RM
07/03/2024
04:49:33 PM
NOTE: Effective June 2024, we will no longer mail out monthly statements. Please contact your local plant to update your email address on file to receive a monthly statement electronically. Weekly invoice delivery will not be impacted.
This invoice is in accordance with your Service Rental Agreement. Please forward to your Accounts Payable Department.
Payment Terms 30 days from invoice date or upon receipt of monthly statement. Thank you for the opportunity to serve ! Docusign Envelope ID: 3DF18E70-EB6C-4ACB-ABED-F3983EABA259 ACORD® CERTIFICATE OF LIABILITY INSURANCE I
DATE (MM/DDIYYYY)
~ 06/1212024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER . THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW . THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER .
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
Marsh Risk & Insurance Services NAME:
PHONE FAX
17901 Von Karman Avenue, Suite 1100 IAJC .,_ E•tl: IAJC Nol:
(949) 399-5800; License #0437153 E-MAIL
ADDRESS : Irvine, CA 92614
INSURER(Sl AFFORDING COVERAGE NAIC#
CN102713954-STND-GAWUW-24- INSURER A : Hartford Fire Insurance Comoanv 19682 INSURED INSURER B : N/A N/A Prudential Overall Supply
P 0. Box 11210 INSURER C : WA N/A
Santa Ana, CA 92711 INSURER D : ~afetv Nalinnal r,e "itv r.nm. 15105 INSURERE :
INSURER F :
COVERAGES CERTIFICATE NUMBER: LOS-002259770-45 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE ADDLSUBR I POLICY EFF POLICY EXP LIMITS LTR 1,.,~n wvn 1 POLICY NUMBER IMM/DD/YYYYl IMM/DD/YYYYl A
~
MERCIAL GENERAL LIABILITY 72CCSOF9345 I 03101,2024 I 0310112025 EACH OCCURRENCE s 1,000,000 CLAIMS-MADE 0 OCCUR
0 A MA<.,C: TO HENTEO
PREMISES (Ea occurrence) s 300,000
MED EXP (Any one person) s 10,000
I
PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 ~
□ PRO - □ LOG
I
PRODUCTS· COMP/OP AGG $ 2,000,000 POLICY JECT
OTHER: $
A AUTOMOBILE LIABILITY I ' 72CSES71000 (CA,AZ,CO,NV, 03/01 /2024 03/01 /2025 COMBINED SINGLE LIMIT s 3,000,000 (Ea accident) ~
ANY AUTO
I
NM, TX,MO,OR,NH, VA,WV,SC,GA) BODILY INJURY (Per person) 1 S OWNED
q
SCHEDULED BODILY INJURY (Per accident) s AUTOS ONLY AUTOS HIRED NON-OWNED 'Auto Phys. Dmg coverage applies I ip~~~~l~le~8AMAGE s .-- AUTOS ONLY .........j AUTOS ONLY I I to Scheduled and Hired Autos only' s
~
' UMBRELLA LIAB
H
OCCUR I EACH OCCURRENCE s
EXCESS LIAB CLAIMS-MADE AGGREGATE s
OED I I RETENTION $ s
WORKERS COMPENSATION I ~l\'tu TE I I OTH-
AND EMPLOYERS' LIABILITY ER
Y / N
ANYPROPRIETOR/PARTNER/EXECUTIVE
□
E.l. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N / A
(Mandatory in NH)
I I
E.l. DISEASE • EA EMPLOYEE! S
If yes, describe under
I I E.l. DISEASE· POLICY LIMIT s DESCRIPTION OF OPERATIONS below D Excess Workers' Compensation
I
SP4066704 I 0110112024 07/01 /2025 Limit 25,000,000
I Employers' Liability .. $750K SIR (AZ) I $1 M SIR (CA) .. Limit 1,000,000
I I I I I
DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
City of Lake Elsinore SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 130 S. Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Lake Elsinore, CA 92530 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
I ~ ~~ & 1~ Setwia4
© 1988-2016 ACORD CORPORATION. All rights reserved .
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Docusign Envelope ID: 3DF18E70-EB6C-4ACB-ABED-F3983EABA259
CITY OF LAKE ELSINORE
TO BE POSTED IN A CONSPICUOUS PLACE
Business Name:
Business Location:
Owner Name(s):
BUSINESS LICENSE NO.
Issue Date: Expiration Date:
BUSINESS LICENSE
THIS IS YOUR LICENSE • NOT TRANSFERABLE
PO BOX 11210 Business Type:
SANTA ANA, CA 92711-1210
PRUDENTIAL OVERALL SUPPLY
PO BOX 11210
SANTA ANA, CA 92711-1210
This business license is issued for revenuepurposes only and does not grant authorization to operate a business. This business license is issued without verification that the holder is subject to or exempted from licensing by t he state, county, feder al government, or any other governmental agency.
Administrative Services - Licensing
130 South Main Street, Lake Elsinore, CA 92530
PH (951 ) 674-3124
PRUDENTIAL OVERALL SUPPLY
CHRIS WELCH
DAN CLARK
MOBILE SERVICE AND/OR DELIVERY
VEHICLES
000471
2/1/2024 1/31/2025
Starting January 1, 2021, Assembly Bill 1607 requires the prevention of gender-based discrimination of business establishments. A full notice is available in English or other languages by going to: https://www.dca.ca.gov/publications/ Docusign Envelope ID: 3DF18E70-EB6C-4ACB-ABED-F3983EABA259 Certificate Of Completion
Envelope Id: 3DF18E70EB6C4ACBABEDF3983EABA259
Status: Completed
Subject: Complete with Docusign: Amendment No. 1 - Prudential Overall Supply.pdf Source Envelope:
Document Pages: 9
Signatures: 5
Envelope Originator:
Certificate Pages: 5
Initials: 0
Carla Khalil
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
130 S. Main Street
Lake Elsinore, CA 92530
[email protected]
IP Address: 76.79.110.130
Record Tracking
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7/24/2024 1:34:57 PM
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[email protected]
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Shannon Buckley
[email protected]
Assistant City Manager
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Barbara Leibold
[email protected]
City Attorney
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JP Landin
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Jason Simpson
[email protected]
City Manager
city of Lake Elsinore
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Signed using mobile
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Luz Reyes
[email protected]
Deputy City Clerk
City of Lake Elsinore
Delegate Of: Candice Alvarez
[email protected]
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Luz Reyes
[email protected]
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City of Lake Elsinore
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If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. To indicate to us that you are changing your mind, you must withdraw your consent using the DocuSign ‘Withdraw Consent’ form on the signing page of a DocuSign envelope instead of signing it. This will indicate to us that you have withdrawn your consent to receive required notices and disclosures electronically from us and you will no longer be able to use the DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from us.
All notices and disclosures will be sent to you electronically Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us.
Electronic Record and Signature Disclosure created on: 2/5/2018 9:41:59 AM Parties agreed to: Shannon Buckley, Barbara Leibold, JP Landin, Jason Simpson How to contact Carahsoft OBO City of Lake Elsinore:
You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows:
To contact us by phone call: 951-674-3124 x269
To contact us by email send messages to: [email protected] To advise Carahsoft OBO City of Lake Elsinore of your new e-mail address To let us know of a change in your e-mail address where we should send notices and disclosures electronically to you, you must send an email message to us at [email protected] and in the body of such request you must state: your previous e-mail address, your new e-mail address. We do not require any other information from you to change your email address..
In addition, you must notify DocuSign, Inc. to arrange for your new email address to be reflected in your DocuSign account by following the process for changing e-mail in the DocuSign system.
To request paper copies from Carahsoft OBO City of Lake Elsinore To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an e-mail to [email protected] and in the body of such request you must state your e-mail address, full name, US Postal address, and telephone number. We will bill you for any fees at that time, if any.
To withdraw your consent with Carahsoft OBO City of Lake Elsinore To inform us that you no longer want to receive future notices and disclosures in electronic format you may:
i. decline to sign a document from within your DocuSign session, and on the subsequent page, select the check-box indicating you wish to withdraw your consent, or you may; ii. send us an e-mail to [email protected] and in the body of such request you must state your e-mail, full name, US Postal Address, and telephone number. We do not need any other information from you to withdraw consent.. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process..
Required hardware and software
Operating
Systems: Windows® 2000, Windows® XP, Windows Vista®; Mac OS® X Browsers:
Final release versions of Internet Explorer® 6.0 or above (Windows only); Mozilla Firefox 2.0 or above (Windows and Mac); Safari™ 3.0 or above (Mac only)
PDF Reader: Acrobat® or similar software may be required to view and print PDF files Screen
Resolution: 800 x 600 minimum
Enabled Security
Settings: Allow per session cookies
** These minimum requirements are subject to change. If these requirements change, you will be asked to re-accept the disclosure. Pre-release (e.g. beta) versions of operating systems and browsers are not supported.
Acknowledging your access and consent to receive materials electronically To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please verify that you were able to read this electronic disclosure and that you also were able to print on paper or electronically save this page for your future reference and access or that you were able to e-mail this disclosure and consent to an address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format on the terms and conditions described above, please let us know by clicking the ‘I agree’ button below.
By checking the ‘I agree’ box, I confirm that:
I can access and read this Electronic CONSENT TO ELECTRONIC RECEIPT OF ELECTRONIC CONSUMER DISCLOSURES document; and
I can print on paper the disclosure or save or send the disclosure to a place where I can print it, for future reference and access; and
Until or unless I notify Carahsoft OBO City of Lake Elsinore as described above, I consent to receive from exclusively through electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to me by Carahsoft OBO City of Lake Elsinore during the course of my relationship with you.