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Contact Information <br /> <br />*all documents must be returned: Master Service Agreement, Statement of Work, and Contact Information Sheet. <br /> <br /> <br /> <br />Organization URL <br /> <br />Street Address <br /> <br />Address 2 <br />City State Postal Code <br />CivicPlus provides telephone support for all trained clients from 7am Î7pm Central Time, Monday-Friday (excluding holidays). <br />Emergency Support is provided on a 24/7/365 basis for representatives named by the Client. Client is responsible for <br />ensuring CivicPlus has current updates. <br /> <br />Emergency Contact & Mobile Phone <br /> <br />Emergency Contact & Mobile Phone <br /> <br />Emergency Contact & Mobile Phone <br /> <br />Billing Contact E-Mail <br />Phone Ext. Fax <br /> <br />Billing Address <br /> <br />Address 2 <br />City State Postal Code <br /> <br />Tax ID # Sales Tax Exempt # <br /> <br />Billing Terms Account Rep <br /> <br />Info Required on Invoice (PO or Job #) <br /> <br />Are you utilizing any external funding for your project (ex. FEMA, CARES): Y \[ \] or N \[ \] <br /> <br />Please list all external sources: <br /> <br /> <br />Contract Contact Email <br />Phone Ext. Fax <br /> <br />Project Contact Email <br />Phone Ext. Fax <br /> <br />th <br /> <br />CivicPlus ¤ 302 S. 4Street, Suite 500 ¤ Manhattan, KS 66502 ¤ www.CivicPlus.com <br />Toll Free 888-228-2233 ¤ Accounting Ext. 291¤ Support Ext. 307 ¤ Fax 785-587-8951 <br />Page 5 of 5 <br /> <br />