7697 - Informal Amendment 3 Executed
DocuSign Transmittal Coversheet
File Name
Purchasing Contact
Docusign Envelope ID: CFFE8317-5EE0-44E8-A4A1-AA4B7931F97F
7697 Integrated Utility Payment Solution
Christina Dormady
Procurement
901 B Texas St., Denton, TX 76209 (940) 349-7100
OUR CORE VALUES
Inclusion Collaboration Quality Service Strategic Focus Fiscal Responsibility
September 19, 2024
Invoice Cloud Inc.
30 Braintree Hill Office Park
Suite 303
Braintree, MA 02184
Re: 7697 Integrated Utility Payment Solutions (the “Contract”)
Dear Mr. O’Brien,
Thank you for being such a valued partner. By signing this Amendment below, COD and Invoice
Cloud Inc. agree that the Contract is hereby deemed amended to the updated Schedule of Charges, as
shown in Attachment A.
Except as amended by this Amendment, the Contract is not otherwise amended and all other terms
and conditions of the Contract remain in full force and effect, as amended hereby. This Amendment
may be executed in any number of counterparts, each of which shall be deemed an original and all of
which together shall constitute one and the same instrument. Signatures transmitted electronically
shall have the same effect as the delivery of original signatures.
The City of Denton reserves the right to re-evaluate pricing as the market conditions change and can
ask your firm to provide updated proposed pricing, including, but not limited to, a decrease in
pricing, as a result of any such change.
We look forward to future business with your firm.
Regards,
____________________________ ___________________________
Christina Dormady, Buyer Kevin O’Brien, CEO
Procurement or Authorized Representative
City of Denton Invoice Cloud Inc.
Docusign Envelope ID: CFFE8317-5EE0-44E8-A4A1-AA4B7931F97F
Price and Service Fee Change Request
SALES INFORMATION
IC Sales Rep Gretchen Schmitt Request Date 9/17/2024
Effective Date 9/17/2024
BILLER INFORMATION
BID # 7697 Invoice Type Name PLUS One Program (Inline Donations)
Biller Name City of Denton Pricing Model (Submitter or Non-Submitter) Non-Submitter
City, State Denton, TX f Non-Submitter: Interchange Paid By Biller
Contact Name Christina Dormady
Contact Title Buyer
Telephone # (940) 349-8006
BILLER PRICING CHANGE REQUEST
CURRENT PRICING
Description Interval Cost Type Cost
NEW PRICING
Description Interval Cost Type Cost
NOTES/SPECIAL HANDLING
SERVICE FEE CHANGE REQUEST
Attachment A
Docusign Envelope ID: CFFE8317-5EE0-44E8-A4A1-AA4B7931F97F
CURRENT SERVICE FEE STRUCTURE
Payment Source Payment Method Min Fee ($) Cost Type Fee Amt
PAYMENT SOURCE EXCEPTIONS
NEW SERVICE FEE STRUCTURE
PAYMENT SOURCE EXCEPTIONS
MAX PAYMENT CAP
CC Max ($) 125000.00 ACH Max ($) 125000.00
NOTES/SPECIAL HANDLING
TRANSACTIONAL PRICING CHANGE REQUEST
CURRENT PRICING
Payment Source Payment Method Fee Rate % Fee Amount $ Additional Fee $
All Payment Sources Credit/Debit/PayPal $0.65
All Payment Sources ACH/EFT $0.50
PAYMENT SOURCE EXCEPTIONS
NEW PRICING
All Payment Sources Credit/Debit/PayPal $0.00
All Payment Sources ACH/EFT $0.00
PAYMENT SOURCE EXCEPTIONS
MAX PAYMENT CAP
Docusign Envelope ID: CFFE8317-5EE0-44E8-A4A1-AA4B7931F97F
CC Max ($) 125000.00 ACH Max ($) 125000.00
NOTES/SPECIAL HANDLING
The purpose of this Price Change Form is to correct a paperwork error on the signed June 6, 2024 Add On Order Form for P-L-U-S One Inline Donations by removing the
credit/debit/paypal and ach/eft transaction fees listed on the Invoice Parameter Sheet under the Transactional Pricing section on the form and in our CRM. These fees will be changed
to $0.00 per transaction for PLUS One Program only. Please sign paperwork so that we can make this change for the City of Denton, TX
[signature page follows]
Docusign Envelope ID: CFFE8317-5EE0-44E8-A4A1-AA4B7931F97F
Accepted by Biller: Accepted by Invoice Cloud, Inc.:
X X
Corporate Officer/Authorized Official Corporate Officer
Christina Dormady Kevin W. O'Brien
Printed Name Printed Name
Buyer CEO
Title Title
Docusign Envelope ID: CFFE8317-5EE0-44E8-A4A1-AA4B7931F97F
Certificate Of Completion
Envelope Id: CFFE83175EE044E8A4A1AA4B7931F97F Status: Completed
Subject: ***Purchasing Approval*** 7697 Integrated Utility Payment Solutions Informal Amendment
Source Envelope:
Document Pages: 6 Signatures: 3 Envelope Originator:
Certificate Pages: 5 Initials: 2 Christina Dormady
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-06:00) Central Time (US & Canada)
901B Texas Street
Denton, TX 76209
christina.dormady@cityofdenton.com
IP Address: 198.49.140.104
Record Tracking
Status: Original
9/19/2024 2:23:46 PM
Holder: Christina Dormady
christina.dormady@cityofdenton.com
Location: DocuSign
Signer Events Signature Timestamp
Christina Dormady
christina.dormady@cityofdenton.com
Buyer
City of Denton
Security Level: Email, Account Authentication
(None)
Completed
Using IP Address: 198.49.140.104
Sent: 9/19/2024 2:26:56 PM
Viewed: 9/19/2024 2:27:04 PM
Signed: 9/19/2024 2:27:36 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Christa Christian
Christa.christian@cityofdenton.com
Purchasing Supervisor
City of Denton
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.104
Sent: 9/19/2024 2:27:38 PM
Viewed: 9/19/2024 2:33:40 PM
Signed: 9/19/2024 2:34:04 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Kevin O'Brien
Kobrien@invoicecloud.com
CEO
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 108.26.157.66
Sent: 9/19/2024 2:34:06 PM
Viewed: 9/20/2024 9:45:06 AM
Signed: 9/20/2024 9:45:18 AM
Electronic Record and Signature Disclosure:
Accepted: 9/20/2024 9:45:06 AM
ID: a02bc29c-0442-46de-b824-bea5342b364a
Christa Foster
Christa.foster@cityofdenton.com
Customer Service Manager
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.104
Sent: 9/20/2024 9:45:20 AM
Resent: 9/26/2024 8:54:33 AM
Viewed: 9/26/2024 9:02:16 AM
Signed: 9/26/2024 9:02:37 AM
Electronic Record and Signature Disclosure:
Accepted: 9/26/2024 9:02:16 AM
ID: 8e307ba8-c8a0-4c61-ac79-bd4a185253cc
Signer Events Signature Timestamp
Christina Dormady
christina.dormady@cityofdenton.com
Buyer
City of Denton
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.10
Sent: 9/26/2024 9:02:39 AM
Viewed: 9/26/2024 9:07:13 AM
Signed: 9/26/2024 9:07:21 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Cheyenne Defee
cheyenne.defee@cityofdenton.com
Procurement Administration Supervisor
City of Denton
Security Level: Email, Account Authentication
(None)
Sent: 9/26/2024 9:07:22 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 9/19/2024 2:26:56 PM
Certified Delivered Security Checked 9/26/2024 9:07:13 AM
Signing Complete Security Checked 9/26/2024 9:07:21 AM
Completed Security Checked 9/26/2024 9:07:22 AM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
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Electronic Record and Signature Disclosure created on: 7/21/2017 3:59:03 PM
Parties agreed to: Kevin O'Brien, Christa Foster
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