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LRC Electronic Payment Acceptance Services 2021STATE OF CALIFORNIA -DEPARTMENT OF GENERAL SERVICES STANDARD AGREEMENT AGREEMENT NUMBER PURCHASING AUTHORITY NUMBER (If Applicable) STD 213 (Rev. 02/2019) 1. This Agreement is entered into between the Contracting Agency and the Contractor named below: CONTRACTING AGENCY NAME City of San Rafael CONTRACTOR NAME Elavon 2. The term of this Agreement is: START DATE June 1, 2021 THROUGH END DATE December 31, 2021 3. The maximum amount of this Agreement is: $ 30,000 4. The parties agree to comply with the terms and conditions of the following exhibits, which are by this reference made a part of the Agreement. EXHIBITS TITLE PAGES Exhibit A Scope of Work 6 Exhibit B Budget Detail and Payment Provisions 3 Exhibit C" General Terms and Conditions S Exhibit D Special Terms and Conditions 8 Exhibit E Fees and Costs 2 Exhibit F Equipment and Software 6 Exhibit G Agreement for Merchant Processing Services Acceptance 16 Items shown with an asterisk I-), are hereby incorporated by reference and made part of this agreement as It attached hereto. These documents can be viewed at https//wwwdgs ca.gov/OLS/Resources/Page-Content/Office-of-Leaal-Services-Resources-List-Folder/Standard-Contract-Longuaae IN WITNESS WHEREOF, THIS AGREEMENT HAS BEEN EXECUTED BY THE PARTIES HERETO. CONTRACTOR CONTRACTOR NAME (if other than an individual, state whether a corporation, partnership, etc.) Elavon, Inc. CONTRACTOR BUSINESS ADDRESS CITY STATE 1211' 7300 Chapman Highway Knoxville TN 37920 PRINTED NAME OF PERSON SIGNING TITLE Timothy I. Miller Senior Vice President, Risk Management Executive CONTRACTOR AUTHORIZED SIGNATU DATE SIGNED Page 1 of 2 STATE OF CALIFORNIA - DEPARTMENT OF GENERAL SERVICES STANDARD AGREEMENT AGREEMENT NUMBER PURCHASING AUTHORITY NUMBER (If Applicable) STD 213 (Rev. 021201 9) STATE OF CALIFORNIA CONTRACTING AGENCY NAME City of San Rafael Page 2 of 2 RAP,q�` 1 s 2 <C1 �o /T�wirH PXA \11 CONTRACT ROUTING FORM INSTRUCTIONS: Use this cover sheet to circulate all contracts for review and approval in the order shown below. TO BE COMPLETED BY INITIATING DEPARTMENT PROJECT MANAGER: Contracting Department: Community Services Project Manager: Catherine Quffa Extension: 3078 Contractor Name: Elavon, Inc Contractor's Contact: Beverly Baker Contact's Email: Beverly.Baker2@elavon.com ❑ FPPC: Check if Contractor/Consultant must file Form 700 Step RESPONSIBLE DESCRIPTION T COMPLETED REVIEWER DEPARTMENT a. Email PINS Introductory Notice to Contractor DATE Check/Initial ❑ 1 Project Manager N/A b. Email contract (in Word) and attachments to City 3/30/2021 ❑X CGQ Attorney c/o Laraine.Gittens@cityofsanrafael.org 2 City Attorney a. Review, revise, and comment on draft agreement 4/9/2021 ❑x LG and return to Project Manager N/A ® LG b. Confirm insurance requirements, create Job on Department Director PINS, send PINS insurance notice to contractor 3 Approval of final agreement form to send to 4/9/2021 © _SAW contractor 4 Project Manager Forward three (3) originals of final agreement to 4/9/2021 ®CGQ contractor for their signature When necessary, contractor -signed agreement 5 Project Manager e ❑X N/A agendized for City Council approval * *City Council approval required for Professional Services ❑ Agreements and purchases of goods and services that exceed Or $75,000; and for Public Works Contracts that exceed $175,000 Click here to PRINT Project Manager Date of City Council approval enter a date. CONTINUE ROUTING PROCESS WITH HARD COPY 4/13/2021 6 Forward signed original agreements to City CGQ City Attorney Attorney with printed copy of this routing form 411131bm 7 Review and approve hard copy of signed agreement 8 City Attorney Review and approve insurance in PINS, and bonds /'� /� (for Public Works Contracts) 9 City Manager/ Mayor Agreement executed by City Council authorized 4tl official 10 City Clerk Attest signatures, retains original agreement and 61 forwards copies to Project Manager 6 7 u /