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CHANGE REQUEST FORMRenaissance Client - City Of Clearwater, FL Change Request Form Sec on ,A - Eaisti I ent G Lange Request Client Name: City Of Clearwater, FL Product: RENAISSANCE Project Type: RENAISSANCE to NAVRISK CR Date: 02.25.2016 v.2 Requested By:Charles Lane Prepared By: Mark Dorn Delivery On Or Before: 12/31/2016 Invoice: Billed Upon CR Approval Client Offer Valid Until 03/25/2016 Description of Change Request: Renaissance to NAVRISK software and technology upgrade client special offer details. Upgrade cost is $10,000. per year paid for four years and includes the software and services noted below. Client will be invoiced as part of this change request for the first year's costs. Asa client convenience the client has until the end of 2016 to schedule and complete their actual upgrade project with the DAVID project manager. The upgrade fee will be added to the clients current support fee invoice for four years as a line item. The existing client support fee will be listed separately and adjusted with any cost of living or CPI increases during the next four years, as noted on the current client support agreement. Services Provided: Included Items • Replace your similar old core Renaissance program modules with new NAVRISK programs. • Provide for free, MMR Integration solution that uses the new Franco Signor /NAVRISK automated MMR program for one RRE. • Provide 1099, ISO, OFAC programs for clients that have current modules and who have existing online services in place. • Provide for free, NAVRISK WC Claimswire Forms program via web services that offers hundreds of WC data forms like FROI. • Provide same quantity of existing Renaissance users licensed for your new NAVRISK system, plus one more free user license. This will be for a total of (5) Named Registered Users. • We will convert client data in core database free from Renaissance to NAVRISK. • Free training via webinar for four (4) training days, or client can elect to pay travel and we will train onsite. • Provide up to forty (40) hours of Project Management services to manage your Renaissance to NAVRISK project upgrade. • Remote Install NAVRISK software on a DAVID SOFTLAYER hosted cloud based system or in -house City Of Clearwater System. Not Included Or Additional Cost Optional Items • For a reduced fee of $150 /hr., any other custom client programming or reports can be recreated or modified for the client. This can include migration of current custom data interfaces, recreating Corvel /EDI interface, Gould & Lamb interface and creating any Check processing layouts. • Client is eligible for a discounted Hosting proposal for SOFTLAYER to host NAVRISK if client decides to move to a hosted technology option verses continuing their current on premise technology processing. Separate CR available for Hosting. Cost is $300 /mo. per user for Hosting and Hosting Support Services. • Onsite installation services work can be provided at the client's request, as a time and travel expense. • Convert or copy client attachment, images or scanned documents into the new database. • NAVRISK program has new optional EDI Integration automation partner interface with HealthTech for an annual fee. • NAVRISK has optional new programs in development the client may license separately at any time in the future. • SAP as a hosted program is $100 /month per user. Additional RRE's for MMR are available at additional cost. e Lion - lied Approved By. W/►' &a n+ & kke A e , e;&., t-4.4.3,„, L , el . eA ,,,,,,t4.-.s,. , Authorized Signature Yee 4--t1-4t 4 .1 5i .5 ^. e..-,e. felte Date: / / 2016 DAVID Corporation Approval: 4 ° l.7 2416 - Mark Dorn, President & CEO Confidential and Pr y DAVID Corporation 1- LOO -55 -0 VIC , www.davidcarp.cor, Renaissance Client — City of Clearwater Change Request Form IN WITNESS WHEREOF, the parties hereto have caused this agreement to be executed on this day of March, 2016. CITY OF CLEARWATER, FLORIDA By: j /J , 1A ■ William B. Home II City Manager Approved as to form: Attest: Paul R. Hull Assistant City Attorney Rosemarie Call City Clerk