ORIGAMI RISK
ORDER FORM #20230808
CONTACT INFORMATION
Client: City of Riverside, California Bill To Contact: Angela Morales Address: 3900 Main Street Bill To Email: [email protected] Riverside, CA 92522
Primary Contact: Jaqueline Godinez Is purchase order (PO) required? X Primary Contact Email: [email protected] Upon entering into this Order Form, please send any Pos. vendor registration links or tax exemption certificates to [email protected]
SUBSCRIPTION DETAILS
Subscription Term: 36 Months
Effective Date: 2023-09-08
RECURRING SUBSCRIPTIONS - LICENSES
Subscription Quantity / Functionality Purchased
RMIS Functionality Selected
Full Users) 25 User(s)
Light Users) 20 User(s)
Certificate of Insurance Tracking 8600 Insureds
Enterprise-Wide Record Entry Up to 1000 records added per year Mobile Forms App License Selected
OCR Scanning License Selected
Annual Total: $117,415.00
RECURRING SUBSCRIPTIONS - HOSTING
Subscription Quantity / Functionality Purchased
Hosting, Network & Storage Up to 25000 Claims), Incidents), Policie(s), and Other Record(s)
Free Non-Searchable File Attachment Storage Includes 100 GBs of Non-Searchable file storage.
Annual Total: $17,250.00
RECURRING SUBSCRIPTIONS - DATA PROCESSING
Subscription Quantity / Functionality Purchased
Accounts Payable 2 Way Interface Integration Selected
CMS-111 Interface Integration Selected
Annual Total: $14,375.00
RECURRING SUBSCRIPTIONS - SUPPORT
Subscription Quantity / Functionality Purchased
Client Support 5 Hour(s) per Month
Annual Total: $15,000.00
ORIGAMI RISK
Annual Fees (before discount): $164,040.00
Discount applied to $164,040.00): ($29,794.00)
Total Annual Fees: $134,246.00
BILLING DETAILS AND ADDITIONAL TERMS
This Order Form is effective as of the Effective Date (as identified above) for the purchase of the subscription services listed above from Origami Risk LLC ("Origami"). This Order Form is subject to all the terms and conditions of the underlying agreement between Client and Origami (the "Agreement"). To the extent the Agreement does not contemplate order forms, this Order Form will be deemed a Statement of Work for purposes of the Agreement. This Order Form will be deemed a part of the Agreement. Origami and Client agree that the term of the Agreement shall be extended through the duration of the term of this Order Form.
Fees for the first year of recurring subscription fees and all one-time fees under this Order Form will be invoiced and due upon execution of this Order Form. Fees for ongoing contract years are due annually upfront on each anniversary date thereafter. All fees are subject to applicable sales tax, which will appear separately on each invoice. All travel costs and expenses will be pre-approved by Client in writing and billed to Client as incurred.
Service descriptions and service-specific terms and conditions are set forth at origamirisk.com/servicedescriptions. which are hereby incorporated by reference in the form available at such link as of the Effective Date. Additional professional services may be set forth in other Statements of Work as agreed between the parties.
ORDER FORM APPROVAL
The undersigned agree to this Order Form.
ORIGAMI RISK LLC CITY OF RIVERSIDE, CALIFORNIA
Rick Stearns
By: Rick Stearns (Aug 2, 2023 10:36 CDT) By:
Rick Stearns
Name: Name:
(Print Name) (Print Name)
Tile: Chief Financial Officer Title:
Date: Aug 2, 2023 Date:
ORIGAMI RISK LLC
Earnest Bentley Attest:
By: Earnest Bentley (Aug 2, 2023 10:35 CDT) City Clerk
Name: Earnest Bentley
Certified as to Availability of Funds:
(Print Name)
Title: President Risk Solutions
Chief Financial Officer
Date: Aug 2, 2023
Approved as to Form:
By Susan wilson
Ison (Aug 3, 2023 07:44 PDT)
Deputy City Attorney