Contract Signature PageFinancial Services • November 10th, 2021
Contract Type FiledNovember 10th, 2021Contract Title P.O. No. or Solicitation No., if any Contract Number Statewide Claims and Investigation Services 2122-01 ITN RM TBD 1. This Contract is entered into between the parties named below, located at the addresses which follow: The Department of Financial Services, 200 East Gaines Street, Tallahassee, FL 32399 (hereinafter called the “Department”) [Contractor’s Name, address] (hereinafter called the “Contractor”) 2. Contract to Begin: Date of Completion: Renewals: May 13, 2022 or the date last signed below, whichever is later (“EffectiveDate”) Up to four (4) years 3. Total Price of Contract Term: Total Price of Renewal Term: Total Price of Contract Term Plus Renewal Term: TBD TBD TBD 4. Performance Bond, if any: Other Bonds, if any: N/A N/A 5. Reference to Appropriation for Year 1 of the Contract (if the Contract is over $5 million pursuant to section 216.313, F.S.): 6. Department’s Contract Manager Contractor’s Contract Manager Name: Address:Phone: