HomeMy WebLinkAbout20171825.tiffBOARD OF COUNTY COMMISSIONERS
PASS -AROUND REVIEW
PASS -AROUND TITLE: Gilbarco, Inc.
DEPARTMENT: Information Technology
PERSON REQUESTING: Ryan Rose, CIO
DATE: 05/28/2021
Brief description of the problem/issue:
Gilbarco, Inc. provides support to Weld County for our Gasboy software/installation.
the Fleet department to manage the fuel disbursement to County vehicles.
This agreement is to add two additional sites to our existing contract. The requested
an additional $1,367 annually.
The software is used by
amount for these sites is
What options exist for the Board? (include consequences, impacts, costs, etc. of options):
This vendor specializes in selling and supporting this software.
Recommendation:
It is recommended that the BOCC approved the agreement for the above specified amount.
Perry L. Buck
Mike Freeman
Scott K. James, Pro-Tem
Steve Moreno, Chair
Lori Saine
66r-yi,at
X41 --mil
Approve Schedule
Recommendation Work Session Other/Comments:
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MEMORANDUM
TO: Esther Gesick, Clerk to the Board June 7, 2021
FROM: Ryan Rose, Chief Information Officer —a.
SUBJECT: Gilbarco, Inc. Agreement
Gilbarco, Inc. provides support to Weld County for our Gasboy software/installation.
The software is used by the Fleet department to manage the fuel disbursement to
County vehicles. The attached agreement between the Board Of County
Commissioners and Gilbarco, Inc. is to add two additional sites to our existing
contract. The cost for this request is $1,367 annually and was reviewed by Legal.
We ask that the BOCC approve the agreement as submitted.
GASBOY
GILBARCO
VEEDER-ROOT
EXHIBIT D-2: REQUEST FORM - ADDITION(S) OF NEW SITES/SERVICES TO GASBOY COVERAGE LIST
ADDENDUM NO. 210519 REQUEST FORM TO ADD NEW SITES/SERVICES TO GASBOY COVERAGE LIST
This Addendum No. 210519 Request Form To Add New Sites or Services To Gasboy Coverage List on the Gasboy Service Agreement
("Addendum") dated 5/20/2021, by and between GILBARCO INC. ("Gilbarco"), and CUSTOMER (as defined below) is an addendum to the
terns set forth in that certain Gasboy Service Agreement dated as of 6/21/2017, by and between Gilbarco and Customer (as amended, the
"Agreement"). Other than the items specifically referred to herein, the parties will continue to operate under the terns and conditions of the
Agreement. Gilbarco and Customer desire to add new sites or services to the Gasboy Service Agreement as follows:
Change Requested: Adding new sites or services to the customer's site list for Gasboy coverage.
(Site detail, Coverage Type, and Billing info required):
GVR Site ID: 855818
Site Name: Weld County Grader Shed
Site PH #: 970-400-2544
Site Address:
17605 CO Rd 96 Nunn, CO 80648
Renewal Period:
5/30/2021— 7/21/2022
Gasboy Service Description
Islander Prime Annual SW Support
Gasboy Service List Price, per year:
638.00
Gasboy Service Renewal Price, prorated (if applicable)
729.00
GVR Site ID: 872384
Site Name: Weld County Mead
Site PH #: 970-400-2544
Site Address:
5698 WCR 34, Platteville, CO 80651
Renewal Period:
5/30/2021— 7/21/2022
Gasboy Service Description
Islander Prime Annual SW Support
Gasboy Service List Price, per year:
638.00
Gasboy Service Renewal Price, prorated (if applicable)
729.00
Return signed and initialed request form to Email: gvr.gso.ser.ServiceOrder(2eilbarco.com
All capitalized terms used hereto and not otherwise defined shall have the same meanings given such terms in the Agreement. This Addendum
shall be incorporated into the Agreement and made a part thereof. Except as modified by this Addendum, the Agreement shall remain in full
force and effect. In the event that the terms of this Addendum conflict with the terms of the Agreement, as amended, the terms of this Addendum
shall control. This Addendum may be executed in separate counterparts, each of which when so executed and delivered shall be deemed to be an
original and all of which taken together shall constitute the same instrument. This Addendum may also be executed and delivered via electronic
transmission, and any such counterpart shall be deemed an original.
IN WITNESS WHEREOF, the Company has caused this Addendum to be executed by their duly authorized representatives as set forth below.
The individual executing below on behalf of each party warrants that they are an authorized representative of such party, and has the ability to
bind such party to the terms of this Agreement. This Addendum is effective as of the date on which it is accepted by Gilbarco.
CUSTOMER:
Weld County Customer# 127446,
a Colorado o corporation / o limited liability company / X political division (choose one)
By (Signature):
Name (Printed):
Title:
Date:
Steve Moreno
Chair, Board of Weld County Commiss
JUN 1 6 2021
Account 127446 - Weld County - GVR 855818872384 - Multi Site Addendum - 5.20.2021
Gilbarco - Confidential
Page I oft
ATTEST- ,1
Welk t
Board
el GASBOY
40.A GILBARCO
VEEDER-ROOT
(Continuation - REQUEST FORM TO ADD NEW SITES/SERVICES TO GASBOY COVERAGE LIST)
BILLING INFORMATION
Gasboy Service Description
Total # of Sites Covered
Total Amount
0152: Gasboy Service Offering
2
$1458 (plus applicable taxes)
(Required for processing)
Company Name: Weld Countv
Customer# 127446
Address: 915 10th St (PO Box 758) City: Greely St: CO Zip: 80632
Contact Name: Mary Truslow Email Address: mtruslow@weldgov.com
Phone #: 970-400-2518 Fax #: NA Fed Tax ID: 846000813
Account 127446 - Weld County - GVR 855818 872384 - Multi Site Addendum - 5.20.2021
Gilbarco - Confidential
Page 2 of 2
Contract Form
New Contract Request
Entity Information
Entity Name*
GILBARCO VE,EDER-ROOT
Contract Name*
GILBARCO ADDENDUM
Contract Status
CTB REVIEW
Entity ID*
.O0014424
Contract Description*
ADD 2 SITES (NUNN AND MEAD) ONTO EXISTING CONTRACT.
Contract Description 2
Contract Type*
AMENDMENT
Amount*
$1,367.00
Renewable*
YES
Automatic Renewal
Grant
IGA
Department
INFORMATION
TECHNOLOGY-GIS
Department Email
CM-
InformationTechnologyGlS
weldgov.com
Department Head Email
CN1-
InfrrmationTechnologyGlS-
DeptHead weldgov,com
County Attorney
GENERAL COUNTY"
ATTORNEY EMAIL
County Attorney Email
CM-
COUNTYA I I ORNEYgWELDG
OV.COM
If this is a renewal enter previous Contract ID
If this is part of a MSA enter MSA Contract ID
❑ New Entity?
Contract ID
4833
Contract Lead*
MTRUSLOW
Contract Lead Email
mtruslow.Rco.weld.co.us
Requested BOCC Agenda
Date*
06114;2021
Parent Contract ID
Requires Board Approval
YES
Department Project #
Due Date
06 10 2021
Will a work session with BOCC be required?*
NO
Does Contract require Purchasing Dept. to be included?
Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in
OnBase
Contract Dates
Effective Date
Termination Notice Period
Contact Information
Contact Info
Contact Name
Purchasing
Review Date*
05101;2022
Committed Delivery Date
Contact Type Contact Email
Renewal Date*
07;01,2022
Expiration Date
Contact Phone I Contact Phone 2
Purchasing Approver Purchasing Approved Date
CONSENT 06'10'2021
Approval Process
Department Head
RYAN ROSE
DH Approved Date
06.,`10,2021
Final Approval
BOCC Approved
BOCC Signed Date
BOCC Agenda Date
06,E 16; 2021
Originator
MTRUSLOU4
Finance Approver
CONSENT
Legal Counsel
CONSENT
Finance Approved Date Legal Counsel Approved Date
06 10;'2021 06='10,`2021
Tyler Ref #
AG 061621
MEMORANDUM
TO: Esther Gesick, Clerk to the Board June 7, 2021
FROM: Ryan Rose, Chief Information OfficerTT'••
SUBJECT: Gilbarco, Inc. Agreement
Gilbarco, Inc. provides support to Weld County for our Gasboy software/installation.
The software is used by the Fleet department to manage the fuel disbursement to
County vehicles. The attached agreement between the Board Of County
Commissioners and Gilbarco, Inc. is to add two additional sites to our existing
contract. The cost for this request is $1,367 annually and was reviewed by Legal.
We ask that the BOCC approve the agreement as submitted.
BOARD OF COUNTY COMMISSIONERS
PASS -AROUND REVIEW/ WORK SESSION REQUEST
RE: Gilbarco, Inc. Software Maintenance
DATE: May 10, 2017
DEPARTMENT: Information Technology
PERSON REQUESTING: Ryan Rose
Brief description of the problem/issue:
Gilbarco, Inc. provides fuel management software to Weld County. The software is used by the Building and
Grounds department for managing the fuel stations. We are currently on an older version of the software and
need to upgrade it. We have had no maintenance contract for many years and will need one in order to perform
the upgrade.
The attached agreement between the Board of Weld County Commissioners and Gilbarco, Inc. provides funding
for the required maintenance of the software. The requested amount for this service is $3,098.00.
What options exist for the Board? (Include consequences, impacts, costs, etc, of options)
This provider specializes in selling this software which is utilized by the Building and Grounds department to
conduct their daily business.
Recommendation:
Legal has reviewed and approved it. It is recommended that the BOCC approve the agreement for the above
specified amount.
Julie Cozad, Chair
Sean P. Conway
Mike Freeman
Steve Moreno
Barbara Kirkmeyer
e)citSsLiN3- tkYLCID'a
Approvc
Recommendation
x
Schedule
Work Session
Other/Comments:
2017-1825
rr
GILBARCO
VEEDER-ROOT
GASBOYT" SERVICE AGREEMENT
tr GASBOY
THIS GASBOYT" SERVICE AGREEMENT ("Agreement") is by and between GILBARCO INC., a
Delaware corporation, doing business under the GasboyTM brand and located at 7300 West Friendly Avenue,
Greensboro, NC 27110 ("Gasboy") and WELD COUNTY, a political division of COLORADO, with
offices located at 915 10T" STREET (PO BOX 758), GREELEY, CO 80632 ("Customer").
In consideration of the foregoing and other good and valuable consideration, the receipt and sufficiency of
which is hereby acknowledged, both parties intending to be legally bound hereby agree as follows:
TERM
This Agreement shall be effective as of the Effective Date as noted in the signature block below and shall
continue for a period of one (l) year ("Initial Term"), unless earlier terminated as provided in this
Agreement. The Initial Term will be automatically extended for successive one (l) year periods ("Renewal
Term") unless either party provides a written notice of its desire not to renew, no later than thirty (30) days
prior to the expiration of the then -current term. Any Renewal Term will be at the current list price at the time
of renewal. Termination may result from the failure of the Customer to comply with any of the conditions of
this Agreement, or by mutual agreement of both parties.
ENTIRE AGREEMENT AND AMENDMENTS
This Agreement, together with its Exhibits, constitutes the entire agreement between the parties and
supersedes all previous communications, representations, or agreements, either oral or written, between the
parties hereto with respect to the subject matter hereof. No agreement or understanding varying or expanding
this Agreement will be binding upon either party hereto unless it is in writing and signed by a duly authorized
representative hereof. This Agreement may be executed in separate counterparts, each of which when so
executed and delivered shalt be deemed to be an original and all of which taken together shall constitute the
same instrument. This Agreement may also be executed and delivered via electronic transmission, and any
such counterpart shall be deemed an original.
Exhibits:
A) Description of Services
B) Agreement Terms and Conditions
C) Fees and Covered Locations
CY WITNESS WHEREOF, each of the parties has caused this Agreement to be executed, in duplicate, by
its duly authorized representative. The individual executing below on behalf of the Customer warrants that it
is an authorized representative and has the ability to bind the Customer to the terms of this Agreement.
Gasboy is not bound by the terms of this Agreement until its authorized representative has executed this
Agreement in the signature block provided below.
(The rensahrrler of thls page Is intentionally left blank; signature to page to follow.'
I70505_Wchl County_Muhl Sltas Gmboy Service Agreement
Gilberto - Cenildemiel
Page 1 of
,e‘ GILBARCO
VEEDER-ROOT
I ITNESS WHEREOF, the parties hereto have signed this Agreement this /dy of
L� , 2017.
CONf;f'RACT PROFESSIONAL:
By:
Name:
Title, 06).,244 Q L lbe
Date
WELD CO
ATTEST:
Well C
BY:
rk to the Boa
Deputy Clerk
Jelit'oe
170303 Weld Coanty_Mulit Slits 4aihoy Service Agreement
(Alberto - Confidential
Page 2 016
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORA
�-� it/
to Co d, Chair
AP t .D AS "I
2 1 2037
E:
fficial or Department Head
GlLDARCO
VEEDER-ROOT
EXHIBIT A:
DESCRIPTION OF SERVICES
During the Term of the Agreement, Gasboy will provide to the following services (the "Services") to Customer for the Gasboy-
branded products ("Products") that Customer owns:
A. Telephone support for Product questions will be provided Monday through Friday 8AM to 6PM ET. All other times not
stated are considered emergency after hour's support only including but not limited to weekends and holidays. Gasboy's toll -
free service number is (currently 800-444-SS29). This toll free number can be changed at Gasboy's discretion.
13. Software corrections and upgrades to the Products that Customer requires on an "as needed" basis.
C. Fleet head office software service for support of Customer head office location only. If Customer has additional locations
requiring such service, Customer will need to enter into individual service support agreements for such locations.
D. The Services do not Include:
1) On -site support.
2) Any hardware, even if a software correction, software upgrade, or other enhancements or modifications require a
hardware update.
3) Support for questions not relating specifically to the Products, such as, but not limited to, non-Gasboy hardware, and PC
operating systems.
4) Software upgrade installation costs.
SERVICES AT NON-CONTRAC'F LOCATION'S
If Customer requests Services for a location not covered by this Agreement, Gasboy will provide telephone support for a fee of
One Hundred Dollars and No Cents (US $100.00), payable immediately by credit card before Gasboy will provide the Services.
This fee is good for one call, one problem only. If Customer calls with more than one issue at a non -covered location, Gasboy will
charge an additional fee for each issue.
DISCONTINUANCE OF SERVICES
If Customer elects to discontinue the Services at any time due, any reinstatement of the Services will require a new agreement and
a payment of the then -current annual fee. In addition, Gasboy will charge a reinstatement fee of one hundred ten percent (110%) of
the current annual fee prorated by the number of months (to a maximum of twenty-four (24) months) during which the Services
were discontinued.
I?0505 Weld County_MultkS{tes_oashay Service Agreement
Glib tsto - Confidential
Page 9 or S
el GILBARCO
VEEDER-ROOT
EXfi[MT II: AGREF,MENt' nano§ AND CONDITION
' t. Fees for the Services arc paid annually in advance. All fees are
required before Gasboy will provide any Services. "Total fees for the
Services ere set forth in Exhibit C attached hereto and incorporated herein
by reference. Gasboy shall have the right to update the fees each year, and
will provide notice to Customer of any fee changes at least sixty (60) days
before the end of the then -current terns. All fees hereunder are due thirty
(30) days from the dale of invoice. Customer is responsible for- all taxes on
the Services, If any invoice is more than thirty (30) days past due, Gasboy
may, at its option, discontinue the Services until the account is made
current, or terminate the Agreement and seek all fees and costs due under
the Agreement. Gasboy reserves the right to pro -rate annual fees for
Customer locations such that ail Customer locations have a common
renewal date.
2. Provided that all foes are paid in a timely manner, the Services shall
be provided at the locations listed on Exhibit C. Any modifications to
locations on Exhibit C due to changes to Customer's business (such as site
closing, relocation of Products), nurst be provided to Gasboy in writing.
3. if Customer (i) breaches this Agreement and such breach is not cured
within ten (l0) days, or (ii) is the subject of any bankruptcy, insolvency, or
similar proceeding, Gasboy may immediately terminate tho Agreement and
all fees shall become immediately due and payable.
4. To the extent permitted by law, customer shall indemnify, defend, and
(told harmless Gasboy, Including its affiliates, agents, and employees from
and against any and all losses, claims, demands, liabilities, fines, penalties,
assessments, suits, or actions for injuries to or death of any person, or for
loss of, or damage to, the property of any person or persons caused by or
resulting from the negligent acts or omissions (including liability imposed
by statutes, rules, or regulations) of Customer, or its subcontractors,
vendors, agents, officers, or employees. Customer's obligations under this
section shall not apply to the extent that such claims arc caused solely by
the willful misconduct of Gasboy.
5. Except as otherwise specifically provided herein, neither party shall be
liable for any failure to perfonn or for any delay in performing any of its
obligations hereunder caused by circumstances beyond its reasonable
control or which makes performance commercially impracticable,
including, but not limited to, fire, storm, flood, earthquake, hurricane,
tornado, explosion, accident, acts of public enemies, war, rebellion,
insurrections, sabotage, epidemic, quarantine restrictions, labor disputes,
labor shortages, transportation embargoes or delays, inability to secure raw
materials or machinery for the manufacture of products, acts of God, acts of
any government, any agency thereof, judicial actions or any other such
external circumstances.
6, At times, Customer and Gasboy may receive from the other party
certain information marked confidential and proprietary. Both parties agree
to treat such information as confidential, using the same degree of care as it
uses to protect its own confidential information, but no less than reasonable
care. The parties agree not to sue or disclose tat otherwise use such
confidential information of the other patty, except as provided herein or
with the express written consent of the other patty. Either party may use or
disclose the confidential information of the other party (i) es required for
the Services, but only to employees who are bound by written
confidentiality agreements no less stringent than this Section 7, and (ii) as
required by a court order or other legal process. The obligations under this
Section 7 shall survive the ten►►ination of this Agreement by seven (7)
years. if Customer rind Gasboy have executed a separate confidentiality
agreement that might also cover the Confidential Information ("NDA"), this
Agreement Witt not change or abrogate any of the terms of that NDA and
such separate NDA shall riot change or abrogate any of the terms of this
Agreement, even though both agreements may apply to the same
information. in the event thus, notwithstanding the foregoing, one party
("Recipient") shall be compelled by the Information Laws to disclose any
Confidential information of the other party ("Discloser"), Recipient shall,
and shall cause its Representatives to, huffish only that portion of the
Confidential Information that is so legally required. "Information Laws"
means the Freedom of Information Act of 1966 and the regulations
promulgated thereunder, the Electronic Freedom of Information Act of
1996, including without limitation such state's open records/public of
information act as set forth In such state statutes, laws, codes, and the
regulations promulgated thereunder, and any similar apptrcable federal or
1705OS well County_ietaill Sftee Casboy Service Agrtment
Girber<o • Carndentiel
Page 4 ors
state law, order, decree,, rule, or regirtalion (cash as in effect from time to
lime). Nothing herein shall restrict any disclosure of a party's information
that: (A) is or becomes publicly available through no fault of the other
party; (R) is independently developed by the other party; or (C) is received
by the other party ftom a third putty without obligations of confidentiality.
"Representatives" shnll mean the officers, employees, directors, attorneys,
consultants and other agents and advisors of the Recipient, Recipient shall
take all reasonably necessary measures to restrain its Representatives from
making any unauthorized disclosure or use of Confidential Information.
Recipient fbrther agrees that it will be liable for the breach of this
Agreement by any of its Representatives. Gasboy is advised shat as a public
entity, Weld County must comply with the provisions of C,R.S. 24-72-201,
et seq., with regard to public records, and cannot guarantee the
confidentiality of all documents.
7. The Services provided under this Agreement are covered by Gasboy's
current warranty, a copy of which is available upon request. Gasboy
reserves the right to modifj+ such warranty, warranty policies, or warranty
program on thirty (30) days prior written notice to Customer. THE
FOREGOING WARRANTIES ARE iN LIEU OF ALL. OTHER
WARRANTIES - EXPRESS, IMPLIED, OR STATUTORY -
INCLUDING WARRANTIES OF MERCHANTABILITY OR FITNESS
FOR A PARTICULAR PURPOSE, GiLBARCO WILL NOT BE
LIABLE FOR PERSONAL INJURY OR PROPERTY DAMAGE
(UNLESS CAUSED BY GILBARCO'S NEGLIGENCE, AND THEN
ONLY iN THE PROPORTION WHICH GILBARCO'S NEGLIGENCE
BEARS TO THE NEGLIGENCE OF OTHERS IN CAUSING THE
INJURY OR DAMAGE), OR FOR ANY DAMAGES (REGARDLESS OF
THEIR NATURE) CAUSED BY CUSTOMER'S FAILURE 'FO FULFILL
ITS RESPONSIBILITIES AS SET FORTH HEREIN. IN NO EVENT
SHALL GiLBARCO BE LIABLE UNDER THIS AGREEMENT FOR
ANY LOSS OF PROFIT OR REVENUES, OIL SPECIAL, INDIRECT,
INCIDENTAL, CONSEQUENTIAL, OR PUNITiVE DAMAGE.,
INCLUDING, BUT NOT LIMITED TO THOSE BASED UPON A
BREACH OF WARRANTY, OR CONTRACT, NEGILIGENCE, STRICT
TORT, OR ANY OTHER LEGAL, EQUITABLE, OR STATUTORY
LEGAI. THEORY. CHILBARCO'S TOTAL CUMULATIVE LIABILITY
UNDER THIS AGREEMENT SHALL NOT EXCEED THE AMOUNTS
PAID BY CUSTOMER I tEREUNDER.
8. This Agreement shall be govcrrted by Colorado law (but not its
conflict laws). Customer specifically and irrevocably consents to the
jurisdiction of the courts located in North Carolina, Customer may not
assign this Agreement and the rights of the Customer without the prior
written consent of Gasboy. Any attempted assignment in violation of the
provisions hereof shall be null and void and have no effect. If any provision
of this Agreement is finally held by a court of competent jurisdiction to be
unlawful or invalid, the remaining provisions of this Agreement shall
remain in fill force and effect, unless as a result of such =lawful
provisions there is a material failure of consideration as to a Party and such
Party is unwitting to waive such failure.
9, if Customer requests Gasboy to perform activities outside: of the
provision of Services, such additional activities shall be subject to a
separately agreement between the parties.
10, Financial obligations of the County payable after the current fiscal
year are contingent upon funds for that purpose being appropriated,
budgeted and othenvlse made available. Execution of this Agreement by
County does not create an obligation on the part of County to expend Rinds
not otherwise appropriated in each succeeding year.
IL Extension or Modification. Any amendments or modifications to this
agreement shall be in %wiling signed by both parties. No additional services
or work performed by Contract Professional shall be the basis for additional
compensation unless and until Contract Professional has obtained written
authorization and acknowledgement by County for such additional services.
12. Termination. County has the right to terminate this Agreement, wif t
or without cause on thirty (30) days written notice. Furthermore, this
Agreement may be terminated at any time without notice upon a material
breach of the terms of the Agreement.
CiILUARCO
rG. VEEDER-ROOT
EXHIBIT C:
FENS AND COVERED LOCATIONS
PART #
DESCRIPTION
CURRENT LIST
PRICE
(I'cr Year)
RENEWING? --
Y!N
099037
CFN PLUS Annual SW Support
$525.00
Y
x/ unit
099039
Islander PLUS Annual SW Support
$525.00
Y
x3 :nits
099049
TopKAT PLUS Annual SW Support
$525.00
Y
x/ unit
099046
Fleet Head Office Annual SW Support - up to 5
sites
$473.00
Y
x/ unit
Total $ of Renewal (plus applicable faxes):
$3,098.00
'0111.10
SITE,ID
SITE NAME
STREET
CRY
ST
ZIP .
PAM,
247536
Greeley
WELD COUNTY Greeley
1113 H ST
GREELEY
CO
80631
O99O37
247536
Greeley
WELD COUNTY Greeley
1113 H 3'T
GREELEY
CO
8O631
099046
282135
Decono
WELD COUNTY Oacono
500 HWY 52
DACONO
CO
8O514
099039
282136
Ft Lupton
WELD COUNTY Ft Lupton
7625 W COUNTY RD 31
FORT LUPTON
CO
80621
099439
842892
Kersey LNG
WELD COUNTY Kersey LNG
1755 HOLLY AVE
GREELEY
CO
80631
099049
842904
Grover
WELD COUNTY Graver
43339 CR 122
GROVER
CO
80729
099039
Renewal Period: 05-0I-2017 —05-01-2018
Billing Info (Required For Processing — Please include a W-9 Form):
Customer Number: 0900002643 Fed Tax ID #: (NEEDED)
Company Name: WELD COUNTY
Address: 915 10`" ST, PO BOX 758 City: GREELEY St: CO Zip: 80632
Contact Name: Teri Rogers Email Address: trogers@co.weld.co.us
Phone #: 970-400-2544 Fax #:
Payment Method:
❑ Check If paying by credit card (Complete and attach authorization form)
Pig Check 1f paying by check (DO NOT mall your payment until you have received an Invoice!)
If providing a PO number, please list here:
This Agreement is made a part hereof by reference, as fully and to the same extent as if copied at length herein. In the event of a
conflict or discrepancy between the Purchase Order ("PO") and this Agreement, this Agreement shall govern the terms and
conditions of the Services provided by Gasboy.
Are you TAX EXEMPT? YES ❑ NO ❑
If you answered yes, but have not yet provided documentation to Gasboy; please attach a copy when returning this profile.
170505_ Wald County_Multi Silee Gesbuy Service Agreement
(inborn) - Confidential
Page 5 of
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