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5452 - Clear Risk Claim Service, Contract AmendmentDecember 13, 2016 City of Denton, TX 601 E. Hickory, Suite A Denton, Texas USA, 76205 Attention: Howard Martin, Interim City Manager RE: Amendment 2 of the ClearRisk Claims Service Agreement 5452 Dear Mr. Payne, This is to confirm our agreement concerning the Amendment 2 of the ClearRisk Claims Services Agreement effective since January 9th, 2014 (Contract 5452) and entered into with ClearRisk, Inc. (“ClearRisk”), a copy of which is attached hereto for easy reference (the “Service Agreement”) for the same price and term of one (1) year, from January 9th, 2017 to January 9th, 2018. Please note: ClearRisk is initiating a 12.5% increase in 2017 on all annual user licenses and web form fees. This is ClearRisk’s first price increase. However, ClearRisk would like to take this opportunity to extend the term from the initially agreed upon one (1) year renewal term to a three (3) year renewal term (the “Extended Term”). This allows the City of Denton, TX to benefit in a price freeze for the duration of the extended term and not be affected by the 2017 price increase. Any additional user licenses or web forms not currently under contract would also benefit from this price freeze. The total contract shall not-to-exceed $99,000. All the terms and conditions of the Service Agreement shall continue to govern the services rendered by you to ClearRisk during the Extended Term. If the above provisions are acceptable by you, please print and sign two copies of this letter in the space provided below and return one to the undersigned. Sincerely, Craig Rowe CEO & Founder, ClearRisk, Inc. Certificate of Interested Parties Electronic Filing In 2015, the Texas Legislature adopted House Bill 1295, which added section 2252.908 of the Government Code. The law states that the City may not enter into this contract unless the Contractor submits a disclosure of interested parties (Form 1295) to the City at the time the Contractor submits the signed contract. The Texas Ethics Commission has adopted rules requiring the business entity to file Form 1295 electronically with the Commission. Contractor will be required to furnish an original notarized Certificate of Interest Parties before the contract is awarded, in accordance with Government Code 2252.908. The contractor shall: Log onto the State Ethics Commission Website at : https://www.ethics.state.tx.us/whatsnew/elf_info_form1295.htm Register utilizing the tutorial provided by the State Print a copy of the completed Form 1295 Enter the Certificate Number on page 3 of this amendment. Sign and notarize the Form 1295 Email the notarized form to purchasing@cityofdenton.com with the contract number in the subject line. (EX: Contract 1234 – Form 1295) The City must acknowledge the receipt of the filed Form 1295 not later than the 30th day after Council award. Once a Form 1295 is acknowledged, it will be posted to the Texas Ethics Commission’s website within seven business days. Read and Accepted on ___________________________________ ClearRisk, Inc. _______________________________________ Name: Craig Rowe Title: CEO _____________________________________________ TEXAS ETHICS COMMISSION CERTIFICATE NUMBER City of Denton, TX _______________________________________ Howard Martin Interim City Manager Attest: Jennifer Walters, City Secretary _______________________________________________ Approved as to Legal Form: Anita Burgess, City Attorney ___________________________________________________________