HN Collection Preservation Cover.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: 17ACE67C-2CD1-4125-8271-8FD2457A7942
Historic Northampton Inc
0.00
0.00
0.00
171
0.00
X
X
for preservation assessment of its clothing and accessories,
textiles, and furniture collections
3100932-59326
6-23
CPA Collection
Preservation
0.00
0.00
Grant
44516
$128,000.00
Borrowing
CPA c/o Planning & Sustainability
three years from execution date
Revolving
$128,000.00
0.00
$128,000.00
0.00
0.00
0.00
Carolyn S. Misch 6/27/2023 | 1:49 PM EDT
Joyce Karpinski 6/27/2023 | 2:38 PM EDT
6/28/2023 | 2:49 PM EDTWilliam Coffey
6/28/2023 | 3:19 PM EDTCharlene Nardi
6/28/2023 | 4:43 PM EDTGina-Louise Sciarra
348-23