ITPS Master Contract Quarterly Activity Report

Department of Information Services ITPS Master Contract Quarterly Activity Report Reporting Quarter Reporting Month 1 - Year Company (Contractor Name) Contractor Master Contract # Purchaser (Agency Name) Purchaser Number Work Order Number Start Date End Date Work Order Total Amount July July 1 - September 30 2008 Reporting Month 1 Grand Totals $ Certification: By submitting this Report, I/We certify that the information is true and correct. Activity Reporting Schedule - For Activity in: July 1 - September 30 October 1 - December 31 January 1 - March 31 April 1 - June 30 Report & Fee Due Dates October 15th January 15th April 15th July 15th Submit completed Activity Report by email to itpsreports@dis.wa.gov Amount Invoiced Invoice Number Date Invoiced DIS Administrative Fee $ - $ 2.00 $ 5.00 Department of Information Services ITPS Master Contract Quarterly Activity Report Reporting Quarter Reporting Month 2 - Year Company (Contractor Name) Contractor Master Contract # Purchaser (Agency Name) Purchaser Number July 0 0 Work Order Number Start Date July 1 - September 30 2007 Reporting Month 2 Grand Totals Certification: By submitting this Report, I/We certify that the information is true and correct. Activity Reporting Schedule For Activity in: Report & Fee Due Dates July 1 - September 30 October 15th October 1 - December 31 January 15th January 1 - March 31 April 15th April 1 - June 30 July 15th Submit completed Activity Report by email to itpsreports@dis.wa.gov End Date Work Order Total Amount Amount Invoiced Invoice Number Date Invoiced g Month 2 Grand Totals $ - $ - t. DIS Administrative Fee $ 3.00 Department of Information Services ITPS Master Contract Quarterly Activity Report Reporting Quarter Reporting Month 3 - Year Company (Contractor Name) Contractor Master Contract # Purchaser (Agency Name) Purchaser Number July 0 0 Work Order Number Start Date July 1 - September 30 2008 Reporting Month 3 Grand Totals Certification: By submitting this Report, I/We certify that the information is true and correct. Activity Reporting Schedule For Activity in: Report & Fee Due Dates July 1 - September 30 October 15th October 1 - December 31 January 15th January 1 - March 31 April 15th April 1 - June 30 July 15th Submit completed Activity Report by email to itpsreports@dis.wa.gov End Date Work Order Total Amount Amount Invoiced Invoice Number Date Invoiced g Month 3 Grand Totals $ - $ - t. DIS Administrative Fee $ - Department of Information Services ITPS Master Contract Quarterly Activity Report Excerpt from Master Contract terms and conditions DIS Master Contract Administration Fee and Collection All purchases made under this Master Contract are subject to a DIS Master Contract Administration Fee, collected by Contr The Master Contract Administration Fee is two percent (2.0% or .02) of the purchase price for Work Orders valued up to $1 price is defined as total invoice price less sales tax. The Master Contract Administration Fee shall be included in all Contractor Prices listed in Schedule A of this Contract and s Contractor shall hold the Master Contract Administration Fee in trust for DIS until the Fees are remitted to the DIS Master C Activity Reporting Contractor shall submit to the DIS Master Contract Administrator a quarterly Activity Report of all Services purchased under a) This Master Contract number; b) The month in which the purchases occurred; c) Each Purchaser, identified by state, local or educational entity, and each Work Order for each Purchaser making p d) The total amount of money received (excluding sales tax) for each Work Order for each Purchaser; e) The DIS Master Contract Administration Fee for each Work Order for each Purchaser; f) The sum of money received (excluding sales tax) for all Work Orders for each Purchaser and for all Work Orders g) The total amount of the DIS Master Contract Administration Fee. Reports are required to be submitted electronically, in the Microsoft Excel format provided by DIS. Reports are to be sent e The Activity Report and the DIS Master Contract Administration Fee shall be submitted on a quarterly basis in accordance w For Activity in: Report & Fee Due Dates July 1 - September 30 October 15th October 1 - December 31 January 15th January 1 - March 31 April 15th April 1 - June 30 July 15th Activity Reports are required even if no activity occurred. This report may be corrected or modified by the DIS Master Contract Administrator with advance written notice to Contracto Upon request by DIS, Contractor shall provide, in the format requested, the contact information for all Purchasers during the Reporting Quarter Reporting Month - Year Company (Contractor Name) Contractor Master Contract # Purchaser (Agency Name) Purchaser Number Work Order Number From the drop down menu, select the appropriate Reporting Quarter. Note: This cell, in th From the drop down menus, select the appropriate Reporting Month and Year. Include your company's name (consistent with your company's legal name identified in yo only needs to be selected once in the Month 1 Report. Include your company's DIS Master Contract Number. Note: This cell, in the Month 2 & 3 Include Purchaser's name. Example: Department of Information Services. Include Purchaser's agency number, as available. This header is linked to the Office of F boards, commissions and higher education. Example: For Department of Information Se Include each Work Order number that your company has entered into during the Reportin Start Date End Date Work Order Total Amount Amount Invoiced Invoice Number Date Invoiced DIS Administrative Fee Include the start date for the Work Order. Example: 7/15/07. Include the end date for the Work Order. Example: 6/30/08. For each Work Order, include the total budget in US dollars. Example: $52,000.00. Include the amount invoiced to the Purchaser during the Reporting Quarter in US dollars. Include the date for each invoice issued during the Reporting Quarter. Include your company's invoice number for each amount invoiced. Include the DIS Administrative Fee for each Work Order. tration Fee, collected by Contractor and remitted to DIS. r Work Orders valued up to $1 million dollars, and will be one percent (1.0% or .01) for Work Orders valued at, or exceeding, $1 million dolla hedule A of this Contract and shall not be invoiced as a separate line item to Purchaser. e remitted to the DIS Master Contract Administrator, along with the Master Contract Activity Report. f all Services purchased under this Master Contract. The report shall identify: r for each Purchaser making purchases during the reporting quarter; each Purchaser; er; haser and for all Work Orders for all Purchasers; and DIS. Reports are to be sent electronically via E-mail to: itpsreports@dis.wa.gov quarterly basis in accordance with the following schedule: nce written notice to Contractor. on for all Purchasers during the Term of the Master Contract. g Quarter. Note: This cell, in the Month 2 & 3 Reports, is linked to the Month 1 report. The Reporting Quarter only needs to be selected once ng Month and Year. ny's legal name identified in your Master Contract). Note: This cell, in the Month 2 & 3 Reports, is linked to the Month 1 report. The Compan e: This cell, in the Month 2 & 3 Reports, is linked to the Month 1 report. The Contractor Master Contract # only needs to be selected once in mation Services. ader is linked to the Office of Financial Management's policy for Agency Codes & Authorized Abbreviations. Note: Numbers are only availab Department of Information Services, enter "1550". ntered into during the Reporting Quarter. 07. 8. s. Example: $52,000.00. eporting Quarter in US dollars. Example: $12,500.00. ng Quarter. voiced. ued at, or exceeding, $1 million dollars. The purchase uarter only needs to be selected once in the Month 1 Report. to the Month 1 report. The Company (Contractor Name) # only needs to be selected once in the Month 1 Report. ons. Note: Numbers are only available for state agencies,

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