CivicPlus 12/23/2022 - Laserfiche WebLink

Contact Information *all documents must be returned: Master Service Agreement, Statement of Work, and Contact Information Sheet. Organization URL ________________________________________________________________________________________________________________________ Street Address ________________________________________________________________________________________________________________________ Address 2 ________________________________________________________________________________________________________________________ City State Postal Code ________________________________________________________________________________________________________________________ CivicPlus provides telephone support for all trained clients from 7am –7pm Central Time, Monday-Friday (excluding holidays). Emergency Support is provided on a 24/7/365 basis for representatives named by the Client. Client is responsible for ensuring CivicPlus has current updates. ________________________________________________________________________________________________________________________ Emergency Contact & Mobile Phone ________________________________________________________________________________________________________________________ Emergency Contact & Mobile Phone ________________________________________________________________________________________________________________________ Emergency Contact & Mobile Phone ________________________________________________________________________________________________________________________ Billing Contact E-Mail ________________________________________________________________________________________________________________________ Phone Ext. Fax ________________________________________________________________________________________________________________________ Billing Address ________________________________________________________________________________________________________________________ Address 2 ________________________________________________________________________________________________________________________ City State Postal Code ________________________________________________________________________________________________________________________ Tax ID # Sales Tax Exempt # ________________________________________________________________________________________________________________________ Billing Terms Account Rep ________________________________________________________________________________________________________________________ Info Required on Invoice (PO or Job #) ________________________________________________________________________________________________________________________ Are you utilizing any external funding for your project (ex. FEMA, CARES): Y [ ] or N [ ] Please list all external sources: _______________________________________________________________________________________________ Contract Contact Email ________________________________________________________________________________________________________________________ Phone Ext. Fax ________________________________________________________________________________________________________________________ Project Contact Email ________________________________________________________________________________________________________________________ Phone Ext. Fax ________________________________________________________________________________________________________________________ V. PD 06.01.2015-0048 Page 5 of 5 https://www.everettwa.gov/ 98201EverettWA City of Everett 2930 Wetmore Avenue Accounts Payable accountspayable@everettwa.gov 425-257-8746 PO Box 12130 Everett WA X ARPA shellyer@everettwa.govSteven Hellyer 425-257-8777 PO #CB 22999 91-6001248 98206-2130