HomeMy WebLinkAboutTRITECH SOFTWARE SYSTEMSDocuSign Envelope ID: CD08DB69-E937-4C8A-BDFC•7C4F296028C4
�SURANCE NOT ON FILE A-2015-252-01
WC, �i ; MAY NOT PRCrEED
CLERK OF COUNCIL
DATE: ExnmiT E
Pd I 1 r n1y rAumn di Enrollment Form
t) ' Deposit Account Number: 32692
Depositor, Beneficiary and Iron Mountain Intellectual Property Management, Inc. ("Iron Mountain"), hereby
o acknowledge that TriTech Software Systems is the N "Depositor" or ❑ `Beneficiary" referred to in the Escrow
o Agreement that supports Deposit Account Number: 32692 with Iron Mountain as the escrow agent and The City of
N Santa Ana, CA is the ❑ Depositor or N Beneficiary enrolling under this Agreement. ❑ "Depositor" or N `Beneficiary"
hereby agrees to be bound by all provisions of such Agreement.
BENEFICIARY COMPANY NAME: CITY OF SANTA ANA
;A
AUTHORIZED PERSON(S)/NOTICEs TABLE
Please provide the name(s) and contact information of the Authorized Person(s) under this Agreement.
All Notices will be sent electronically and/or through regular mail to the appropriate address set forth
below. Please complete all information as applicable. Incomplete information may result in a delay of
processing.
PRINT NAME:
Kristine Ridge
PRINT NAME:
David Valentin
TITLE:
City Manager
TITLE:
Chief of Police
EMAIL ADDRESS
EMAIL ADDRESS
STREET ADDRESS
20 Civic Center Plaza
STREET ADDRESS
60 Civic Center Plaza
PROVINCE/CITY/STATE
Santa Ana, CA
PROVINCE/CITY/STATE
Santa Ana, CA
POSTAUZIP CODE
92701
POSTAL/ZIP CODE
92701
PHONE NUMBER
714-647-5200
PHONE NUMBER
714-245-8003
FAX NUMBER
FAX NUMBER
PAYING PARTY COMPANY NAME: TRITECH SOFTWARE SYSTEMS
BILLING CONTACT INFORMATION TABLE
Please provide the name and contact information of the Billing Contact under this Agreement. All Invoices
will be sent to this individual at the address set forth below.
PRINT NAME:
CentralSquare Technologies, LLC
TITLE:
Accounting
EMAILADDRESS
Accounts.receivable@centralsquare.com
STREET ADDRESS 1
1000 Business Center Drive
PROVINCE/CITY/STATE
Lake Mary, Florida
POSTAUZIP CODE
32746
PHONE NUMBER
800-727-8088
FAX NUMBER
(407) 304-3914
IRON MOUNTAIN INTELLECTUAL PROPERTY MANAGEMENT, INC.
All notices should be sent to iomcontractsna ironmountain.com OR Iron Mountain-Attn: Contract
Administration, 2100 Norcross Parkway, Suite 150, Norcross, Georgia, 30071, USA.
NOTE: SIGNATURE BLOCKS FOLLOW ON THE NEXT PAGE
DocuSign Envelope ID: CD08D869-E937-4C8A-BDFC-7C4F296028C4
DEPOSITOR r—Doouslgnea by:
SIGNATURE:
u�
PRINT NAME:
MAIVA&I,
TITLE:
Director of Contracts
DATE:
01/28/2020
EMAIL ADDRESS
Kevin.price@centralsquare.com
BENEFICIARY
SIGNATURE:
PRINT NAME: Kristine Ridge
TITLE: City Manager
DATE:
EMAIL ADDRESS:
IRON MOUNTAIN INTELLECTUAL PROPERTY MANAGEMENT, INC.
'"ammag
i
or :. R. i1
APPROVED AS TO FORM:
SONIA R. CARVALHO
CITY RNEY
BY:
TAMARA, BIWOSTAN
ASSISTANT CITY ATTORNEY
RECOMMENDED FOR APPROVAL:
CHIEF OF POLICE
NOTICE OF COMPLIANCE
CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL
Contractor
CentralSquare Technologies, LLC
Name:
Project
A-2015-252
Number:
Project
System Purchase And Support Agreement
Name:
The Certificate of Insurance (COI) submitted indicates that the coverages are in
compliance with the insurance requirements. No further action is required at this time.
The compliant coverage(s) are:
EXPIRATION COI
TYPE OF INSURANCE POLICY NUMBER FILE NAME
DATE DATE
AUTOMOBILE CentralSquareCOI_22-
BA6S7835392213G 08/31/2023 01/03/2023
LIABILITY 23.pdf
CentralSquareCOI_22-
GENERAL LIABILITY H63065758660COF22 08/31/2023 01/03/2023
23.pdf
WORKERS cert_ATL_City of
COMPENSATION AND UB6S78366822I3G 08/31/2023 01/03/2023 Santa
EMPLOYERS' LIABILITY Ana_5306760_11.pdf
Thank you,
City of Santa Ana
Risk Management Division
in partnership with
CTrax Plus Services Team
1/17/2023 3:33 PM