Laserfiche WebLink
DocuSign Envelope ID:2BA5E40A-FF10-4F0E-ACB6-711 F2F7F2DFF <br /> AI, Anoka County <br /> HUMAN SERVICES DIVISION <br /> Community Social Services and Behavioral Health <br /> April 25,2023 <br /> City of Centerville <br /> Attn: Mark Statz <br /> 1880 Main Street <br /> Centerville,MN 55038 <br /> Dear Mr. Statz: <br /> Enclosed is your 2023 contract with Anoka County. Please review the contract and complete the signature portion using <br /> DocuSign. If applicable and ready, please attach the necessary insurance information using the attachment link in the <br /> DocuSign document. If insurance is not ready and you will be sending this information at a later date,please send to: <br /> Angie Rodine <br /> Angela.Rodine@co.anoka.mn.us or County of Anoka <br /> 2100 3rd Avenue, 5th Floor <br /> Anoka,MN 55303 <br /> PLEASE NOTE: The following information is required as part of your contract. If the contract is signed and executed <br /> without receiving this information in a timely manner, it may be referred to the County Attorney's Office for possible <br /> Breach of Contract and/or payments may be withheld until information is received <br /> CERTIFICATE OF LIABILITY INSURANCE-Required <br /> No insurance information is needed for this contract. <br /> CONTRACTOR INFORMATION SHEET-Required <br /> Please update/complete and sign this page and return with your contract. <br /> DocuSign will automatically forward a copy of the signed contract to you,once completed. If you have questions regarding <br /> the contract,please call your Contract Manager,Justin Navratil,at 763-324-4336. <br /> Sincerely, <br /> Angie Rodine <br /> Administrative Assistant, Planning and Operations Support Services <br /> Meeting People's Needs Through Quality Services <br /> Community Social Services&Behavioral Health <br /> Government Center ♦ 2100 3rd Avenue N.STE 500 A Anoka.MN 55303-5049 <br /> PHONE 763-324-1400 ♦ FAX. 763-324-1110 <br /> Affirmative Action/Equal Opportunity Employer <br />