HomeMy WebLinkAboutC22-244 Quality Health NetworkProduct/Services Order Dated: 06/22/2022
Exhibit B Addendum of QHN eCommerce Agreement Dated: 11/10/2020
Order is valid for 30 days
Quality Health Network Product/Services Order Form. Revised January 2022.
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Sold To
Name: Eagle County Government
Address: PO Box 660, Eagle, CO 81631
Contact Name: Jeff Schroll
Contact Phone: 970-471-0112
Contact Email: jeff.shroll@eaglecounty.us
QHN Products and Services One Time Fees Monthly Fees
Statement of Work (SOW) detail below or attached (rate = $150/hr):
QHN will set up and train up to 10 users with access to the Community
Resource Network (CRN) for the Healthy Families Division of Eagle County
Public Health and Environment.
PAID FOR BY
GRANT
PAID FOR BY
GRANT
Travel expenses (mileage at IRS allowed rate - $0.56) $0 $0
Sub Total: PAID FOR BY
GRANT
PAID FOR BY
GRANT
Adjustments: PAID FOR BY
GRANT
PAID FOR BY
GRANT
Total Amount Due: PAID FOR BY
GRANT
PAID FOR BY
GRANT
Amounts will be due under this Order when Specified work is complete. Work is considered complete when system is
available for productive use. License and Services Fees are delivered pursuant to the eCommerce Agreement with QHN.
Special Fee Schedules may apply for special situations. Travel & out-of-pocket expenses are invoiced to Participant as
incurred. Add-on Users to be invoiced per the current QHN fee schedule. QHN is not responsible for any Participant
vendor fees that may apply.
Signature below authorizes delivery of products and services listed pursuant to eCommerce Agreement.
Executed by: ____________________________________________________ Date:
Authorized Participant Signature
Printed name: ___Jeff Shroll, County Manager _________________________________________________ Advisor: Sherri Corey
Printed Name and Title
Notes: Access to CRN for up to 10 users will be grant funded until October 31st, 2022. On October 31st, 2022, this
order will expire and a new agreement for CRN access will need to be put into place.
DocuSign Envelope ID: 5BB8BE85-44CB-4BFD-B625-4C7BA1971A53
7/5/2022