blank_vendor_cover-DS-1.doc.pdfMayor’s/CP docs/Procedures/VENDOR.COVER SHEET.UPDATED.6-02 cp
City of Northampton
Vendor Contract Cover Sheet
(To Accompany All City Contracts to City Auditor, Purchasing and Mayor’s Office)
1. Department and/or Division Name:
2. Vendor Name:
3. Munis Vendor I.D.#:____________ Department Contract # (if any):
4. Source and Amount of Funds: Please Fill in Below
Source: (Please check
all that apply) Account
Name:
Account
Number:
Amount: Total Per
Source
Budget:
Total of Contract
5. Period of Contract Coverage (If Applicable) ___________________________________________
6. Brief Description of Goods and/or Services being provided (e.g., Is this a part of a larger project,
stand alone, or is it an amendment to a contract?):
7. Does the vendor have a Northampton Office: ____ Yes _ No
(if local) Taxes owed: ____ Yes ____ No
8. Please list time and dates that contracts were delivered:
Signature Date
Department Head, _________________ ___ _______________
Auditor, _________________________ ___ _______________
Chief Procurement Officer, __________ _____________________ _______________
Finance Director, __________________ ___ _______________
Mayor ___________________________ ___ _______________
Contract #:
DocuSign Envelope ID: 99F07623-F3CA-468D-9E4F-E7E8EBCD36E9
Community Preservation c/o Office of Planning & Sustainability
0.00
31647 remit 2
3100931-593195-22
0.00
Grant
20,000.00
3 years from contract date
0.00
Borrowing
20,000.00
X
Grow Food Northampton
X
0.00
Revolving
0.00
0.00
150
0.00
0.00
GFN Farmland
Reclamation
0.00
20,000.00
creation of additional community garden plots and/or edible
hedgerows, and reclaim farm field edges
0.00
Wayne Feiden, Director of Planning & Sustainability1/5/2022 | 4:54 PM EST
1/6/2022 | 8:39 AM ESTJoyce Karpinski
1/6/2022 | 4:06 PM ESTJoe Cook
1/6/2022 | 4:10 PM ESTCharlene Nardi
1/6/2022 | 6:51 PM ESTGina-Louise Sciarra
186-22