210000000214.pdf

STATE OF MICHIGAN PROCUREMENT

Department Technology, Management and Budget Central Procurement Services 320 S Walnut Street Lansing, MI 48933 P.O. Box 30026, Lansing, MI 48909

CONTRACT CHANGE NOTICE

Change Notice Number 16 to

Contract Number MA210000000214

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EVANS CASELOAD INC

2014 Champions Gateway, Suite 301

Canton OH 44708

Taylor Smith

330-470-4254

Taylor.Smith@equivant.com

CV0066977

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Pr og ra m

M an ag er

Various Various

C on tr ac t Ad m in is tr at or Anna Krupka DTMB

517-855-8801

KrupkaA@michigan.gov

CONTRACT SUMMARY

MyCaseload Enhanced Document Management

INITIAL EFFECTIVE DATE

December 15, 2020

INITIAL EXPIRATION DATE

April 11, 2025

INITIAL AVAILABLE OPTIONS

5 - 1 Year

EXPIRATION DATE BEFORE

April 11, 2027

PAYMENT TERMS

NET 45

DELIVERY TIMEFRAME

N/A

ALTERNATE PAYMENT OPTIONS

P-Card Direct Voucher (PRC) Other

EXTENDED PURCHASING

Yes No

MINIMUM DELIVERY REQUIREMENTS

N/A

DESCRIPTION OF CHANGE NOTICE

OPTION LENGTH OF OPTION EXTENSION LENGTH OF EXTENSION

REVISED EXP. DATE

CURRENT VALUE

$2,153,180.47

VALUE OF CHANGE NOTICE

$32,370.01

ESTIMATED AGGREGATE CONTRACT VALUE

$2,185,550.48

DESCRIPTION

Please note the Program Manager or Contract Administrator may have changed, and are reflected on this Change Notice.

Effective 06/30/2026, this Contract is increased by $32,370.01 for annual Software subscription and Unemployment Insurance Appeals Commission license.

All other terms, conditions, specifications and pricing remain the same. Per contractor and agency agreement, and DTMB Central Procurement Services approval.

CHANGE NOTICE NO. 16 TO CONTRACT NO. MA210000000214

Program Managers for

Multi-Agency and Statewide Contracts

AGENCY NAME PHONE EMAIL

DTMB Stuart Willard 517-284-5300 WillardS@michigan.gov

DTMB Michael Weiszbrod 517-242-1272 WeiszbrodM@michigan.gov

LEO Julie Petrik 517-284-9319 PetrikJ@michigan.gov

LARA Suzanne Sonneborn 517-335-7661 SonnebornS@michigan.gov

DTMB William Metz MetzW@michigan.gov

LARA Patricia Halm HalmP1@michigan.gov

Department Technology, Management and Budget Central Procurement Services 320 S Walnut Street Lansing, MI 48933 P.O. Box 30026, Lansing, MI 48909

CONTRACT CHANGE NOTICE

Change Notice Number 15 to

Contract Number MA210000000214

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EVANS CASELOAD INC

2014 Champions Gateway, Suite 301

Canton OH 44708

Taylor Smith

330-470-4254

Taylor.Smith@equivant.com

CV0066977

ST

AT

E

Pr og ra m

M an ag er

Various Various

C on tr ac t Ad m in is tr at or Anna Krupka DTMB

517-855-8801 krupkaa@michigan.gov

CONTRACT SUMMARY

MyCaseload Enhanced Document Management

INITIAL EFFECTIVE DATE

December 15, 2020

INITIAL EXPIRATION DATE

April 11, 2025

INITIAL AVAILABLE OPTIONS

5 - 1 Year

EXPIRATION DATE BEFORE

April 11, 2026

PAYMENT TERMS

NET 45

DELIVERY TIMEFRAME

N/A

ALTERNATE PAYMENT OPTIONS

P-Card Direct Voucher (PRC) Other

EXTENDED PURCHASING

Yes No

MINIMUM DELIVERY REQUIREMENTS

N/A

DESCRIPTION OF CHANGE NOTICE

OPTION LENGTH OF OPTION

1 Year

EXTENSION LENGTH OF EXTENSION REVISED EXP. DATE

April 11, 2027

CURRENT VALUE

$1,990,725.47

VALUE OF CHANGE NOTICE

$162,455.00

ESTIMATED AGGREGATE CONTRACT VALUE

$2,153,180.47

DESCRIPTION

Please note the Program Manager or Contract Administrator may have changed, and are reflected on this Change Notice.

Effective 03/31/2026, this Contract is exercising the second option year and is increased by $162,455. The revised contract expiration date is 04/11/2027. Per Contractor, Agency, DTMB Procurement and State Administrative Board approval on 03/31/2026.

CHANGE NOTICE NO. 15 TO CONTRACT NO. MA210000000214

Program Managers for

Multi-Agency and Statewide Contracts

AGENCY NAME PHONE EMAIL

LEO Julie Petrik 517-284-9319 PetrikJ@michigan.gov

DTMB Michael Weiszbrod 517-242-1272 WeiszbrodM@michigan.gov

DTMB Stuart Willard 517-284-5300 WillardS@michigan.gov

LARA Suzanne Sonneborn 517-335-7661 SonnebornS@michigan.gov

DTMB William Metz MetzW@michigan.gov

STATE OF MICHIGAN

ENTERPRISE PROCUREMENT

Department of Technology, Management, and Budget 320 S. Walnut Street 2nd Floor Lansing, MI 48933

P.O. BOX 30026 LANSING, MICHIGAN 48909

CONTRACT CHANGE NOTICE

Various Mecca Martin

(517) 230-5694

MartinM42@michigan.gov

STATE CONTACTS

DTMBC

ontract

A dm inistrator

Program

M anager

Various

Evans Caseload Inc. d/b/a equivant

2014 Champions Gateway, Suite 301 Canton OH 44708

Taylor Smith

330-470-4254

Taylor.Smith@equivant.com

CV0066977

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CONTRACT SUMMARY

MyCaseload Enhanced Document Management

INITIAL EFFECTIVE DATE INITIAL EXPIRATION DATE INITIAL AVAILABLE OPTIONS EXPIRATION DATE BEFORE December 15, 2020 April 11, 2025 5 - 12 Months April 11, 2025

PAYMENT TERMS DELIVERY TIMEFRAME

ALTERNATE PAYMENT OPTIONS EXTENDED PURCHASING

MINIMUM DELIVERY REQUIREMENTS

N/A

P-Card Direct Voucher (PRC) Other NoYes

N/ANET 45

Contract Number MA210000000214 to

Evans Caseload Inc. d/b/a equivant

4450 Belden Village Street, Suite 305 Canton OH 44720

Stuart Rosove

330.470.0816

Stuart.rosove@equivant.com

CV0066977

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Change Notice Number 14

DESCRIPTION OF CHANGE NOTICE

OPTION EXTENSIONLENGTH OF OPTION LENGTH OF EXTENSION REVISED EXP. DATE

CURRENT VALUE VALUE OF CHANGE NOTICE ESTIMATED AGGREGATE CONTRACT VALUE

12 Months April 11, 2026

$1,831,456.47 $159,269.00 $1,990,725.47

Effective 4/12/2025, this Contract is exercising the 1st option year and is increased by $159,269.00 and utilizes $31,734.00 of available funds per Attachment 1 - Pricing. The revised contract expiration date is 4/11/2026.

Contractor and State of Michigan Unemployment Insurance Appeals Commission (UIAC) will separately and in good faith negotiate the terms of a data sharing agreement, separate from and in addition to the Contract, which will include acknowledgments for Contractor staff that access State Data that contains data provided by UIAC.

All other terms, conditions, specifications and pricing remain the same. Per contractor and agency agreement, and DTMB Central Procurement Services approval.

AGENCY NAME PHONE EMAIL

DTMB Michael Weiszbrod 517-242-1272 WeiszbrodM@michigan.gov

LEO Julie Petrik 517-284-9319 PetrikJ@michigan.gov

LARA Suzanne Sonneborn 517-335-7661 SonnebornS@michigan.gov

DTMB Stuart Willard 517-284-5300 WillardS@michigan.gov

Program Managers for

Multi-Agency and Statewide Contracts

CHANGE NOTICE NO. 14 TO CONTRACT NO. MA210000000214

ATTACHMENT 1 - PRICING

Software Subscription Cost

Period of Coverage: April 12, 2025 – April 11, 2026

• MOAHR - Medicaid Annual Software Subscription - $17,226.00

• MI TAX Tribunal- Annual Software Subscription - $22,637.00

• MOAHR- Annual Software Subscription - $112,127.00

• Document Packaging Module Subscription - $1,213.00

• Case Archiving Module Subscription - $6,066.00

Software Subscription Total: $159,269.00

Maintenance & Support Cost

Period of Coverage: July 1, 2025 – June 30, 2026

• Unemployment Insurance Appeals Commission – Annual Software Subscription - $31,734.00

Maintenance & Support Total: $31,734.00

ENTERPRISE PROCUREMENT

Department of Technology, Management, and Budget 320 S. Walnut Street 2nd Floor Lansing, MI 48933

P.O. BOX 30026 LANSING, MICHIGAN 48909

CONTRACT CHANGE NOTICE

Various Mecca Martin

517-230-5694

MartinM42@michigan.gov

STATE CONTACTS

DTMBC

ontract

A dm inistrator

Program anager

Various

Equivant

4450 Belden Village Street, Suite 305 Canton OH 44720

Stuart Rosove

330.470.0816

Stuart.rosove@equivant.com

VS0329480

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CONTRACT SUMMARY

MyCaseload Enhanced Document Management

INITIAL EFFECTIVE DATE INITIAL EXPIRATION DATE INITIAL AVAILABLE OPTIONS EXPIRATION DATE BEFORE December 15, 2020 April 11, 2025 5 - 12 Months April 11, 2025

PAYMENT TERMS DELIVERY TIMEFRAME

ALTERNATE PAYMENT OPTIONS EXTENDED PURCHASING

MINIMUM DELIVERY REQUIREMENTS

N/A

P-Card Direct Voucher (PRC) Other NoYes

N/ANET 45

Contract Number MA210000000214 to

EVANS CASELOAD INC

1915 Danforth Avenue Toronto ON M4C 1J5 Stuart Rosove

330.470.0816

Stuart.rosove@equivant.com

CV0066977

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Change Notice Number 13

DESCRIPTION OF CHANGE NOTICE

OPTION EXTENSIONLENGTH OF OPTION LENGTH OF EXTENSION REVISED EXP. DATE

CURRENT VALUE VALUE OF CHANGE NOTICE ESTIMATED AGGREGATE CONTRACT VALUE

$1,459,138.62 $372,317.85 $1,831,456.47

Effective 8/20/2024, this Contract is increased by $372,317.85 for Department of Laor and Economic Opportunity (LEO) for cost associated with adding and Public Portal and Licenses to UIAC myCaseLoad.

The following amendment(s) are incorporated into this Contract per the attached Statement of Work to have a public portal added to the UIAC case management system myCaseLoad; and adds a Data Request for Information Form.

All other terms, conditions, specifications, and pricing remain the same. Per contractor and agency agreement, DTMB Central Procurement Services approval, and State Administrative Board approval on 8/20/2024.

LARA Giget Schlyer 517-582-8330 schlyerg@michigan.gov

DTMB Stuart Willard 517-284-5300 WillardS@michigan.gov

Program Managers for

CHANGE NOTICE NO. 13 TO CONTRACT NO. MA210000000214

MICHIGAN DEPARTMENT OF TECHNOLOGY,

MANAGEMENT AND BUDGET

IT SERVICES

STATEMENT OF WORK FOR IT CHANGE NOTICES

Project Title:

UIAC MyCaseLoad

Period of Coverage:

12/15/2020 – 4/11/2025

Requesting Department:

LEO - UIAC

Date:

4/30/2024

Agency Project Manager:

Julie Petrik

Phone:

517-284-9319

DTMB Project Manager:

Michael Weiszbrod

Phone:

517-242-1272

PROJECT OBJECTIVE:

To enhance the efficiency of filing and processing appeals, providing parties with effortless tracking of their case status and submissions. equivant will develop a software system to automate the filing and processing of appeals, along with providing easy tracking of case status and submissions for involved parties.

SCOPE OF WORK:

Estimates for this project were based upon the understanding and development of the forms found in Appendix A of this document and the workflow adjustments set forth in Appendix B. Upon completion of the information gathering phase, a review of the scope and budget will take place to ensure that the requirements fall within the general estimates. Should there be a change from the originally planned requirements, the UIAC will be provided with a quotation to address these previously unknowns. When UIAC has this pricing information, they will be able to conduct a cost-benefit analysis to confirm that need for the customization or if a workaround will suffice. The project schedule will also be reviewed and altered as needed based on the documented requirements.

DELIVERABLES:

Deliverables will not be considered complete until the Agency Project Manager has formally accepted them. Deliverables for this project include:

Deliverables for Site Setup Information Gathering Sessions:

• Project Site Setup

• Information Gathering Session

Deliverables for System Development:

• Community configuration

• Development of online forms as set forth in Appendix A

• Workflow and Template adjustments as set forth in Appendix B

Deliverables for Project Site Testing:

• Project Site Issue Resolution

• Configured system ready for shipment to UIAC

Deliverables for Local Install and User Acceptance Testing

• Host Environment Specification

• Creation of Host Environment (UIAC)

• Host Environment Evaluation

• Installation of Community and myCaseLoad software applications

• UAT Assistance

Deliverables for Admin Trainer and Go Live

• Administrative overview

• Go Live support

Deliverables for Project Management

• Updated Statement of Work

• Updated Project Schedule

• Project Status Reports (ongoing throughout the project)

ACCEPTANCE CRITERIA:

As defined in the contract

PROJECT CONTROL AND REPORTS:

The equivant Project Manager will create a project schedule that will be submitted with this Statement of Work to adjust for any changes agreed to as part of the agreement process as well as any other required and agreed upon adjustments. The deliverable will be an updated Project schedule in the form of an Excel file.

The equivant project manager will provide the following project management services throughout the project:

• Coordination of project resources and work so that milestones are achieved in an efficient manner.

• Serve as the main point of contact for your project.

• Provide updates to the work plan and project budget as appropriate.

• Participate in project status meetings and steering committee meetings.

• Provide monthly project status reports.

• Update risk and issue management document as appropriate.

• Provide scope change management.

• Provide deliverable management including obtaining UIAC acceptance of project deliverables.

• Process project invoices.

• Conduct project closeout meeting.

equivant will issue a monthly report containing a Project Status Summary to enable regular and clear communications. This will include equivant staffing labor data extracted from equivant’s internal time tracking system and will report out activity, including remaining project hours available, for the previous month.

The monthly Project Status Summary will be due within fifteen (15) calendar days at the end of each month. The reports shall contain:

• Summary overview of activity during the report period

• Milestone Completion changes during the report period

• Schedule status

• Action Items

• Escalated Issues & Risks identified during the report period.

SPECIFIC DEPARTMENT STANDARDS:

Equivant must complete a Data Request Application in order to have access to any portion of the current UIAC Production myCaseLoad database. This is to be in compliant with existing agency data governance policy.

PRICING TABLES

Product Product Type Quantity Unit Price Subtotal Extended Price myCaseLoad API Module License 1 40,440.00$ 40,440.00$ 40,440.00$ E-Filing Module License 1 33,700.00$ 33,700.00$ 33,700.00$

Subtotal 74,140.00$

Professional Services - Training Service 1 800.00$ 800.00$ 800.00$ Professional Services - Workflow Development & Configuration Service 1 35,800.00$ 35,800.00$ 35,800.00$ Professional Services - User Acceptance Testing Service 1 9,600.00$ 9,600.00$ 9,600.00$ Professional Services - Template Development Service 1 17,600.00$ 17,600.00$ 17,600.00$

Professional Services - Custom Software Development Service 1 4,800.00$ 4,800.00$ 4,800.00$ Professional Services - Information Gathering & Documentation Service 1 46,000.00$ 46,000.00$ 46,000.00$ Professional Services - Development Service 1 65,600.00$ 65,600.00$ 65,600.00$ Professional Services - Project Management Service 1 46,400.00$ 46,400.00$ 46,400.00$ Professional Services - Technical Setup Service 1 5,600.00$ 5,600.00$ 5,600.00$

Subtotal 232,200.00$

306,340.00$

Yr. 1 Maintenance Maintenance 15569 1.00$ 15,569.00$ 15,569.00$ Subtotal 15,569.00$

15,569.00$

321,909.00$

Product Product Type Quantity Unit Price Subtotal Extended Price

Exchange Module Extension (5) License 1 674.00$ 674.00$ 674.00$ Standard Edition User License 9 2,296.00$ 20,664.00$ 20,664.00$

Subtotal 21,338.00$

21,338.00$

Yr. 1 Maintenance Maintenance 1 5,245.00$ 5,245.00$ 5,245.00$ Yr. 2 Maintenance Maintenance 1 5,507.25$ 5,507.25$ 5,507.25$ Yr. 3 Maintenance Maintenance 1 5,782.60$ 5,782.60$ 5,782.60$ Yr. 4 Maintenance Maintenance 1 6,115.00$ 6,115.00$ 6,115.00$ Yr. 5 Maintenance Maintenance 1 6,421.00$ 6,421.00$ 6,421.00$

Subtotal 29,070.85$

29,070.85$

50,408.85$

372,317.85$ SOW Grand Total

Recurring Total

User Licenses One Time Costs

One Time Total

Recurring Costs

Recurring Total

Community Total

Community One Time Costs

Recurring Costs

One Time Total

User Licenses Total

PAYMENT SCHEDULE:

Payment will be made on a satisfactory acceptance of each Milestone basis. DTMB will pay CONTRACTOR upon receipt of properly completed invoice(s) which shall be submitted to the billing address on the State issued purchase order not more often than monthly. DTMB Accounts Payable area will coordinate obtaining Agency and DTMB Project Manager approvals. All invoices should reflect actual work completed by payment date, and must be approved by the Agency and DTMB Project Manager prior to payment. The invoices shall describe and document to the State’s satisfaction a description of the work performed, the progress of the project, and fees. When expenses are invoiced, receipts will need to be provided along with a detailed breakdown of each type of expense.

Payment shall be considered timely if made by DTMB within forty-five (45) days after receipt of properly completed invoices.

EXPENSES:

The State will NOT pay for any travel expenses, including hotel, mileage, meals, parking, etc.

PROJECT CONTACTS:

The designated Agency Project Manager is:

Name Julie Petrik Department Labor Economic and Opportunity (LEO) Area Unemployment Insurance Appeals Commission (UIAC) Address 525 W Allegan City/State/Zip Lansing, Michigan 48933 Phone Number 517-284-9319 Email Address petrikj@michigan.gov

The designated DTMB Project Manager is:

Name Michael Weiszbrod Department DTMB Area Agency Services Address 4125 W St Joe Hwy City/State/Zip Lansing, Michigan 48917 Phone Number 517-242-1272 Email Address weiszbrodm@michigan.gov

AGENCY RESPONSIBILITIES:

DTMB and UIAC is responsible for maintaining a host environment with the necessary hardware, operating system, and database software to support the myCaseLoad applications.

Assisted access to the host environment will be made available to equivant for the purposes of the software installation and for ongoing support of the CMS software application and database. An equivant technical specialist will perform a validation of the host environment prior to installation of the application and database software. Should the host environment not meet the minimum requirements, a list of deficiencies will be provided. Deficiencies will be mitigated prior to the commencement of application and database installation activities.

LOCATION OF WHERE THE WORK IS TO BE PERFORMED:

Consultants will work at vendor location.

EXPECTED CONTRACTOR WORK HOURS AND CONDITIONS:

Work hours are not to exceed eight (8) hours a day, forty (40) hours a week. Normal working hours of 8:00 am to 5:00 pm are to be observed unless otherwise agreed to in writing.

No overtime will be permitted.

Appendix A

UIAC Website Forms and Workflow 1 Explanatory Note regarding highlighted numbers: The form numbers are highlighted to indicate a same or similar workflow as others highlighted in the same color.

No. Last Date Revised

Form Notes Workflow

1 8/31 JP Notice of Appearance Send task to file prep on case when filing received.

File prep individual will validate and complete.

File prep will continue with correcting NORA and sending out as needed.

2 8/31 JP Appeal Send appeal to new shared dashboard for Form 2, 6 & 7 File prep individual will select case and validate.

Additional case information pulls over from MOAHR.

Case set up will continue per current procedures and workflows.

3 8/31 JP Application for Oral Argument

Send task to file prep on case when filing received.

File prep individual will validate and select how to move the case forward per current initiate correspondence workflow.

4 8/31 JP Application for Written Argument

Send task to file prep on case when filing received.

File prep individual will validate and select how to move the case forward per current initiate correspondence workflow.

5 8/31 JP Application to Present Additional Evidence

Send task to file prep on case when filing received.

File prep individual will validate and select how to move the case forward per current initiate correspondence workflow.

6 8/31 JP Rehearing Request Send appeal to new shared dashboard for Form 2, 6 & 7 File prep individual will select case and validate.

Case set up will continue per current procedures and workflows.

7 8/31 JP Reopening Request Send appeal to new shared dashboard for Form 2, 6 & 7 File prep individual will select case and validate.

Case set up will continue per current procedures and workflows.

8 Application for Transfer Send Application to new shared dashboard for Form 8 only.

File prep individual will select case and validate.

Case set up will continue per current procedures and workflows.

9 8/31 JP Address Change-Party Send task to file prep on case when filing received.

File prep individual will accept/validate.

10 8/31 JP Address Change- Agent/Rep/Atty

Send task to file prep on case when filing received.

File prep individual will accept/validate.

11 Information Requests (Status Requests/verify receipt of documents/requests for copies, request for audio recording

Send task to file prep on case when filing received.

File prep individual will validate and complete request/action asked for.

Appendix B

Title Description

Custom Workflow Adjustments – Appeal (Form #2)

A new workflow will be created to handle the validation and extraction of case details from MOAHR similar to what the current manual case intake does. A new list definition for the group resource dashboard will have to be created to include the option for a user to assign themselves as the task actor instead of the group resource.

A new dashboard be configured for a group resource.

Custom Workflow Adjustments – Application for Transfer (Form #2)

A new workflow will be created to handle the validation and extraction of case details from MOAHR similar to what the current manual application for transfer intake does

Custom Workflow Adjustments – Create Document Types

Subsequent filings that are submitted via Community will create specific document types on a case and specific tasks for a shared resource or specific resource assigned to the case. A new workflow will be created for UIAC to validate/accept the filing and complete the task created by Community.

Custom Workflow Adjustments – Address Party Change

Community will create the new person’s address based on the form contents, but this will be flagged as inactive and create a task for UIAC resource to validate/accept the change. A new workflow will be created for UIAC to accept or reject the change. If the change is accepted, the address will be activated as mailing address.

Custom Workflow Adjustments – Address Change Agent

Community will create the new counselor office address based on the form contents. This may require at least 3 levels of changes as the counselor office includes the relationship to a firm, an office, and the counselor (representative). A new workflow will need to be created for UIAC users to accept the address change. An additional complexity for this change will need to be discussed with UIAC if this change will have to be applied only on the case or to be cascaded to other active cases of the agent/representative.

Generate Closing Mailing Packet Adjustments

The current workflow needs to be adjusted to handle the delivery of documents via email and print. Currently, everything is generally printed and sent via snail mail. Changing the delivery method from Print to email may require reconfiguration of packets to handle the combining of multiple documents for email delivery ( i.e. one single attachment instead of multiple attachments) as well as adjusting current workflow to handle packaging of documents specifically for split scenarios where some recipients will get the documents via email while other recipients will have to get the printed copy.

GRETCHEN WHITMER DEPARTMENT OF LABOR AND ECONOMIC OPPORTUNITY

GOVERNOR UNEMPLOYMENT INSURANCE AGENCY

SUSAN R. CORBIN

DIRECTOR

Authorized by MCL 421.1 et seq. •

UIA is an equal opportunity employer/program. • *064392109*

UIA 6439

(Rev. 9-21)

PUBLIC OFFICIAL, EDUCATIONAL INSTITUTION, OR MICHIGAN WORKS! AGENCY

REQUEST FOR INFORMATION

The Michigan Employment Security (MES) Act and Michigan Administrative Code, in conjunction with the Code of Federal Regulation, 20 CFR 603, authorizes the Unemployment Insurance Agency (UIA) to release unemployment insurance data. UIA may only release this data pursuant to an agreement and if the statutory requirements for disclosure are met.

To receive data, the following requirements must be met:

1. The requesting individual or entity is an authorized requestor pursuant to statute and rule.

2. The purpose for which the data is requested is an authorized purpose pursuant to statute and rule.

3. The requesting individual or entity must enter into a written agreement to receive the data.

4. The requesting individual or entity must agree to reimburse UIA for the cost of providing the data.

UIA data can be requested for the fourth quarter of 2013 through present. If your request is for data prior to the fourth quarter of 2013, there will be an additional cost to obtain this data which must be paid by the requestor. If you cannot provide the Social Security Number (SSN) of the individuals for whom you are requesting data, you must provide each individual’s first name, middle initial and last name, address, date of birth and gender. There wil also be an additional cost to obtain data requested without SSNs.

To submit a data request, complete this form and return it via email to LEO-UIAdatarequests@michigan.gov or by fax to 313-456-2733. Do not send data with this request. You will be notified when to provide individual data to fulfill your request if approved.

Describe the records requested. Be specific and include the time period for which you are requesting data:

Describe in detail the purpose for which you are requesting data. This must be specific and not general in nature:

I affirm that the information provided on this form is accurate. I understand that if I misrepresent information, I may be subject to penalties under Section 54 of the MES Act.

Signature Date

Print Name Telephone Number

Title Email Address

Entity

UIA 6439

(Rev. 9-21)

Describe how the data is to be used. Include whether you plan to redisclose the data, and if so, in what form and to whom:

If you have questions, contact UIA at LEO-UIAdatarequests@michigan.gov.

You will receive a confirmation letter that your request was received. Once your request is reviewed, you will receive notice as to whether your request was approved or denied. If approved, a cost estimate will be provided, and you will receive a tentative agreement. After the agreement has been approved and fully executed, you will be invoiced for the cost estimate. Upon receipt of payment, the data request and transfer will be executed. After the transfer of data, you may receive a second invoice for the actual cost including transfer fees. The invoice must be paid within 30 days or the agreement will automatically terminate and you must destroy the data pursuant to the terms of the agreement. You will need to ensure that all legal and technical requirements for your entity have been addressed prior to the transfer of data.

If you would like more information on requesting unemployment insurance data, see Fact Sheet #170, Unemployment Insurance Data Requests, available at www.michigan.gov/uia under Tools & Resources, Fact Sheets.

Which of the following describes the requestor? Select one.

Public Official An agency of this state that is acting as a contractor or agent of a public official and conducting research that assists the public official in carrying out the duties of the office.

Eligible Educational Institution Independent Educational Institution Michigan Works! Agency

A public office or agency of a local unit of government within the Michigan works area.

An entity organized under the urban cooperation act of 1967, 1967 (Ex Sess) PA 7, MCL 124.501 to 124.512, or 1967 (Ex Sess) PA 8, MCL 124.531 to 124.536.

Other: _________________________________________________________________________

I would like to:

apply)

CENTRAL PROCUREMENT SERVICES

Department of Technology, Management, and Budget

320 S. WALNUT ST., LANSING, MICHIGAN 48933

P.O. BOX 30026 LANSING, MICHIGAN 48909

CONTRACT CHANGE NOTICE

Change Notice Number 12 to

Contract Number 210000000214

Various

Jeremy Lyon daevans@caseload.com

Darryl Evans

Toronto, ON M4C 1J5

EVANS CASELOAD INC

CV0066977

416-762-0236

1915 Danforth Avenue

(517) 230-2858 S

T A

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P ro g ra m a n a g e r

C o n tra ct

A d m in istra to r

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DTMB

lyonj5@michigan.gov

$1,255,426.92

December 15, 2020 April 11, 2025

MYCASELOAD ENHANCED DOCUMENT MANAGEMENT

April 11, 2025

INITIAL AVAILABLE OPTIONS EXPIRATION DATE

BEFORE

5 - 1 Year

PAYMENT TERMS DELIVERY TIMEFRAME

ALTERNATE PAYMENT OPTIONS EXTENDED PURCHASING

☐ P-Card ☐ PRC ☐ Other ☐ Yes ☒ No

MINIMUM DELIVERY REQUIREMENTS

DESCRIPTION OF CHANGE NOTICE

OPTION LENGTH OF OPTION EXTENSION LENGTH OF EXTENSION REVISED EXP. DATE

☐ ☐ April 11, 2025

CURRENT VALUE VALUE OF CHANGE NOTICE ESTIMATED AGGREGATE CONTRACT VALUE

$156,146.70 $1,411,573.62

Effective 3/8/2024, this change to add funds to contract to renew myCaseLoad and Community system annual maintenance.

MAHS- Medicaid Annual Software Subscription (04/11-24-04/10/25)- $16,888.02 MI TAX Tribunal- Annual Software Subscription (04/11-24-04/10/25)- $22,193.13 MAHS- Annual Software Subscription (04/11-24-04/10/25)- $109,928.91

Document Packaging Module Subscription (04/11-24-04/10/25)- $1,189.44 Case Archiving Module Subscription (04/11-24-04/10/25)- $5,947.20

All other terms, conditions, specifications and pricing remain the same. Per contractor and agency agreement, and DTMB Central Procurement Services approval.

INITIAL EXPIRATION DATEINITIAL EFFECTIVE DATE

DESCRIPTION

CONTRACT SUMMARY

LARA

Program Managers for

CHANGE NOTICE NO. 12 TO CONTRACT NO. 210000000214

Cole Thelen 517-388-8350 thelenc10@michigan.govLARA

Stuart Willard 517-284-5300 WillardS@michigan.govDTMB

Department of Technology, Management, and Budget

320 S. WALNUT ST., LANSING, MICHIGAN 48933

P.O. BOX 30026 LANSING, MICHIGAN 48909

CONTRACT CHANGE NOTICE

Change Notice Number 11 to

Contract Number 210000000214

Various

Jeremy Lyon daevans@caseload.com

Darryl Evans

Toronto, ON M4C 1J5

EVANS CASELOAD INC

CV0066977

416-762-0236

1915 Danforth Avenue

(517) 230-2858 S

T A

T E

P ro g n a g e r

C o n tra ct

A d m in istra to r

C O

N T R A C T O

R

DTMB

lyonj5@michigan.gov

$1,153,006.92

December 15, 2020 December 14, 2025

MYCASELOAD ENHANCED DOCUMENT MANAGEMENT

April 11, 2025

INITIAL AVAILABLE OPTIONS EXPIRATION DATE

BEFORE

5 - 1 Year

PAYMENT TERMS DELIVERY TIMEFRAME

ALTERNATE PAYMENT OPTIONS EXTENDED PURCHASING

☐ P-Card ☐ PRC ☐ Other ☒ Yes ☐ No

MINIMUM DELIVERY REQUIREMENTS

DESCRIPTION OF CHANGE NOTICE

OPTION LENGTH OF OPTION EXTENSION LENGTH OF EXTENSION REVISED EXP. DATE

☐ ☐ December 14, 2025

CURRENT VALUE VALUE OF CHANGE NOTICE ESTIMATED AGGREGATE CONTRACT VALUE

$102,420.00 $1,255,426.92

Effective 9/14/2023, this change adds funding for the Michigan Tax Tribunal (MITAT) in the amount of $102,420.00. The following amendments are incorporated into this Contract per the attached SOW.

1. Setting up the current MITAT environment on CaseLoad servers.

2. Rebuilding the MITAT online forms to align with modern web technologies.

3. Upgrading myCaseLoad (including any templates and workflows) and Community on the CaseLoad servers.

4. Testing and validating the upgraded system by CaseLoad and MITAT subject matter experts.

5. Package and install myCaseLoad and Community into the MITAT environment.

6. Community Administration training for the chosen Administrator.

All other terms, conditions, specifications,and pricing remain the same. Per contractor and agency agreement, DTMB Central Procurement Services approval, and State Administrative Board approval on 9/14/2023.

INITIAL EXPIRATION DATEINITIAL EFFECTIVE DATE

DESCRIPTION

Program Managers for

CHANGE NOTICE NO. 11 TO CONTRACT NO. 210000000214

Giget Schlyer 517-582-8330 schlyerg@michigan.govLARA

Michigan Tax Tribunal – 2023 Upgrade of myCaseLoad and Community

Period of Coverage:

08/07/2023-12/31/2023

Requesting Department:

LARA

Date:

08/04/2023

Agency Project Manager:

Justin Padgett

Phone:

517-282-6783

DTMB Project Manager:

Katy Stevenson

Phone:

517-899-7234

Brief Description of Services to be provided:

BACKGROUND:

myCaseLoad

This statement of work (SOW) is intended to provide details related to the Michigan Tax Tribunal’s (MITAT) request to upgrade their instance of myCaseLoad and Community.

PROJECT OBJECTIVE:

This project will involve:

1. Setting up the current MITAT environment on CaseLoad servers.

2. Rebuilding the MITAT online forms to align with the modern web technologies.

3. Upgrading myCaseLoad (including any templates and workflows) and Community on the CaseLoad servers.

4. Testing and validating the upgraded system by CaseLoad and MITAT subject matter experts.

5. Package and install myCaseLoad and Community into the MITAT environment.

6. Community Administration training for the chosen Administrator.

SCOPE OF WORK:

The scope of work will be broken down in the following manner:

Site Setup

A copy of MITAT’s current myCaseLoad and Community sites will be setup in the CaseLoad environment and will be used for conversion and initial testing before packaging and delivery for installation in the MITAT environment.

Form Re-creation

As a result of the newer web framework that will be utilized by Community, the online forms currently in use will be updated. All 10 forms in use will be recreated and they include:

1. Property Tax Appeal Petition Form: Valuation/Poverty/Classification

2. Property Tax Appeal Petition Form Principal Residence/Qualified Agricultural Exemption

3. Property Tax Appeal Petition Form: Special Assessment

4. Tax Appeal Petition Form: Non-Property

5. Property Tax Appeal Answer Form: Valuation/Poverty/Classification

6. Property Tax Appeal Answer Form: Principal Residence/Qualified Agricultural Exemption

7. Property Tax Appeal Answer Form: Special Assessment

8. Tax Appeal Answer Form: Non-Property

9. Entire Tribunal Case Information Sheet (Must Upload Petition)

10. Entire Tribunal Case Information Sheet (Must Upload Answer)

Testing

• Initial testing will be conducted by CaseLoad and the MITAT subject matter experts to ensure system operates as designed.

Local Installation

• CaseLoad will assist with local installation of the upgraded systems in the MITAT test environment where final testing will take place.

• CaseLoad will assist with the switchover to the production environment.

TASKS:

Technical support is required to assist with the following tasks:

DELIVERABLES:

The following items will be the deliverables for this project:

1. Upgraded myCaseLoad (with associated templates and workflows) and configured Community systems in CaseLoad’s test environment.

2. Delivery of myCaseLoad and Community systems for installation into the MITAT environment for local testing.

Assumptions and Dependencies

The following assumptions have been considered as part of this statement of work:

1. CaseLoad may require a copy of MITAT’s current myCaseLoad and Community components.

2. MITAT staff will be available to review and validate the upgraded site that will be setup in the CaseLoad environment.

3. An upgrade of MITAT’s current myCaseLoad system will be required.

4. MITAT will have an assigned administrator/trainer for the Community system.

5. MITAT will provide the local test environment and testers to perform local user acceptance testing.

6. Any users of the current MITAT online system that will be migrated over to the upgraded Community site will need to update their login password.

ACCEPTANCE CRITERIA:

[If not defined within the Contract]

PROJECT CONTROL AND REPORTS:

A bi-weekly progress report must be submitted to the Agency and DTMB Project Managers throughout the life of this project. This report may be submitted with the billing invoice. Each bi-weekly progress report must contain the following:

1. Hours: Indicate the number of hours expended during the past two weeks, and the cumulative total to date for the project. Also state whether the remaining hours are sufficient to complete the project.

2. Accomplishments: Indicate what was worked on and what was completed during the current reporting period.

3. Funds: Indicate the amount of funds expended during the current reporting period, and the cumulative total to date for the project.

SPECIFIC DEPARTMENT STANDARDS:

Agency standards, if any, in addition to DTMB standards.

Payment will be based upon the satisfactory acceptance of each milestone upon completion.

All invoices must include the purchase order number to avoid delay in payment.

Invoicing Breakdown Invoicing will be broken out into 5 invoices with the first 1 falling within the current fiscal year (before October 1, 2023) and the remaining invoices will be created in the next fiscal year. This will address the Department’s desire to ensure distribution of invoices across 2 fiscal years.

# Description Amount Fiscal Year 1 Setup and Planning $ 34,920.00 Before Oct

1, 2023/FY23 2 Workflow and Template

Upgrades $ 16,290.00

3 Development 50% $ 20,925.00 After Oct 1, 2023/FY24 4 Development 50% $ 20,925.00

5 Training/UAT $ 9,360.00

Total cost: $102,420 (excluding taxes)

Payment will be made on a [Insert one from above] basis. DTMB will pay CONTRACTOR upon receipt of properly completed invoice(s) which shall be submitted to the billing address on the State issued purchase order not more often than monthly. DTMB Accounts Payable area will coordinate obtaining Agency and DTMB Project Manager approvals. All invoices should reflect actual work completed by payment date, and must be approved by the Agency and DTMB Project Manager prior to payment. The invoices shall describe and document to the State’s satisfaction a description of the work performed, the progress of the project, and fees. When expenses are invoiced, receipts will need to be provided along with a detailed breakdown of each type of expense.

Payment shall be considered timely if made by DTMB within forty-five (45) days after receipt of properly completed invoices.

EXPENSES:

The State will NOT pay for any travel expenses, including hotel, mileage, meals, parking, etc.

PROJECT CONTACTS:

The designated Agency Project Manager is:

Name Justin Padgett Department MI Department of Licensing and Regulatory Affairs Area Michigan Office of Administrative Hearings and Rules Building/Floor Address City/State/Zip Phone Number 517-282-6783 Fax Number Email Address padgettJ2@michigan.gov

Name Katy Stevenson Department MI Department of Technology, Management and Budget Area AS-LARA Building/Floor Ottawa, 1st Floor Address 611 W Ottawa City/State/Zip Lansing, MI Phone Number 517-899-7234 Fax Number

Email Address stevensonk1@michigan.gov

AGENCY RESPONSIBILITIES:

LOCATION OF WHERE THE WORK IS TO BE PERFORMED:

Consultants will work at (identify location) in Lansing, Michigan.

EXPECTED CONTRACTOR WORK HOURS AND CONDITIONS:

Work hours are not to exceed eight (8) hours a day, forty (40) hours a week. Normal working hours of 8:00 am to 5:00 pm are to be observed unless otherwise agreed to in writing.

No overtime will be permitted.

PROJECT PLAN: (examples listed in table below)

Project Schedule

Note: These dates are for sample purposes and will be finalized as part of the initial phase.

ID Task ode

Task Name Duration Start Finish

1 MITAT Communit Upgrade 137 days Mon 23-07-17 Wed 24-01-31 2 Start Project 1 day Mon 23-07-17 Mon 23-07-17 3 Send current copy of production databases 1 day Tue 23-07-18 Tue 23-07-18 4 Setup mCL and Community site on CaseLoad servers 1 day Wed 23-07-19 Wed 23-07-19 5 Setup of technical environment in MITAT 1 day Wed 23-07-19 Wed 23-07-19

6 Create Project Schedule 1 day Mon 23-07-17 Tue 23-07-18 7 Review and Confirm Project Schedule 1 day Wed 23-07-19 Wed 23-07-19 8 Invoice - Setup and Planning 0 days Thu 23-07-20 Thu 23-07-20 9 Kickoff 1 day Mon 23-07-24 Mon 23-07-24 10 Internal Review and Mapping 13 days Tue 23-07-25 Fri 23-08-11 11 Modify workflows and templates for mCL and Community 20 days Mon 23-08-14 Mon 23-09-11 12 Invoice - Workflow and Template Upgrades 0 days Tue 23-09-12 Tue 23-09-12 13 Form Devlopment 50 days Mon 23-08-14 Tue 23-10-24 14 Property Tax Appeal Petition Form: Valuation/Poverty/Classification 5 days Mon 23-08-14 Fri 23-08-18 15 Property Tax Appeal Petition Form Principal Residence/Qualified Agricultura 5 days Mon 23-08-21 Fri 23-08-25 16 Property Tax Appeal Petition Form: Special Assessment 5 days Mon 23-08-28 Fri 23-09-01 17 Tax Appeal Petition Form: Non-Property 5 days Tue 23-09-05 Mon 23-09-11 18 Property Tax Appeal Answer Form: Valuation/Poverty/Classification 5 days Tue 23-09-12 Mon 23-09-18

19 Property Tax Appeal Answer Form: Principal Residence/Qualified Agricultural 5 days Tue 23-09-19 Mon 23-09-25

20 Property Tax Appeal Answer Form: Special Assessment 5 days Tue 23-09-26 Mon 23-10-02 21 Invoice - 50% of Development 0 days Fri 23-10-20 Fri 23-10-20 22 Tax Appeal Answer Form: Non-Property 5 days Tue 23-10-03 Tue 23-10-10 23 Entire Tribunal Case Information Sheet (Must Upload Petition) 5 days Wed 23-10-11 Tue 23-10-17 24 Entire Tribunal Case Information Sheet (Must Upload Answer) 5 days Wed 23-10-18 Tue 23-10-24 25 Additional adjustments 5 days Wed 23-10-25 Tue 23-10-31 26 Testing of Community in CaseLoad environment 15 days Wed 23-11-01 Tue 23-11-21 27 Fixing of Community related items 15 days Wed 23-11-01 Tue 23-11-21 28 Invoice - 50% of Development 0 days Wed 23-11-22 Wed 23-11-22 29 Local install of Community 10 days Wed 23-11-22 Tue 23-12-05 30 User Acceptance Testing 10 days Wed 23-12-06 Tue 23-12-19 31 Community Admin Training 1 day Wed 23-12-20 Wed 23-12-20 32 Invoice - Setup/Training/UAT 0 days Thu 23-12-21 Thu 23-12-21 33 Prepare Production Environment 5 days Thu 23-12-21 Fri 23-12-29 34 Go Live 0 days Mon 24-01-15 Mon 24-01-15

Tasks & Deliverables Requirements

Antici pated Start Date

Anticipat ed

Completi on Date

Contractor Staff Role Hour s Rate Total Accept ance /

Signoff Total

Payment

Milestone I Project Plan UAT Changes Production Changes

Task I Project Plan

Schedule Project Manager

State

PM &

Project Sponsor

Planning

Task II Business

Requirements Documentation

Business Analyst

Document Requirem ents Develop Stories

State

PM &

Analysis

Task III Development

Functional Design Document

Consistent with SOM Supplied

EASA Drawings Install Guide with

Installable Software for UAT

UAT Approved Software Satisfying the JIRA Requirements

Listed

System Architect

Design Interfaces Configure Enhance ments

Task IV Assist SOM in creating Test

Approach, Test Plan, and Test

Cases Documentation

QA Lead

Design Testing Approach System Test

Testing

Task V Deployment of Accepted

Environment to Production

Infrastructur e

Deployme nt Team

State

PM &

Deployment

Task VI Warranty Support of

Install Software Support Support

State

PM &

Warranty

Task VII Migration Migration of Data

Infrastructur e

Migration Plan, Mapping and Validation

TOTAL

Department of Technology, Management, and Budget

320 S. WALNUT ST., LANSING, MICHIGAN 48933

P.O. BOX 30026 LANSING, MICHIGAN 48909

CONTRACT CHANGE NOTICE

Change Notice Number 10 to

210000000214Contract Number

Various

Jeremy Lyon matt.goddard@volarisgroup.com

Matt Goddard

Canton, OH 44718

EVANS CASELOAD INC

CV0066977

905-271-4050

4450 Belden Village Street Suite 305

(517) 230-2858 S

T A

T E

P ro g n a g e r

C o n tra c t

A d m in is tra to r

C O

N T

R A

C T

O R

DTMB

lyonj5@michigan.gov

$1,153,006.92

December 15, 2020 December 14, 2025

MYCASELOAD ENHANCED DOCUMENT MANAGEMENT

April 11, 2025

INITIAL AVAILABLE OPTIONS EXPIRATION DATE

BEFORE

5 - 1 Year

PAYMENT TERMS DELIVERY TIMEFRAME

ALTERNATE PAYMENT OPTIONS EXTENDED PURCHASING

☐ P-Card ☐ PRC ☐ Other ☒ Yes ☐ No

MINIMUM DELIVERY REQUIREMENTS

DESCRIPTION OF CHANGE NOTICE

OPTION LENGTH OF OPTION EXTENSION LENGTH OF EXTENSION REVISED EXP. DATE

☐ ☐ April 11, 2025

CURRENT VALUE VALUE OF CHANGE NOTICE ESTIMATED AGGREGATE CONTRACT VALUE

$0.00 $1,153,006.92

Effective 4/13/2023, this change is to make a clerical change to the expiration date. The change will reflect the new revised expiration to be 4/11/2025.

All other terms, conditions, specifications and pricing remain the same. Per contractor and agency agreement, and DTMB Central Procurement Services approval.

INITIAL EXPIRATION DATEINITIAL EFFECTIVE DATE

DESCRIPTION

Program Managers for

CHANGE NOTICE NO. 10 TO CONTRACT NO. 210000000214

Department of Technology, Management, and Budget

320 S. WALNUT ST., LANSING, MICHIGAN 48933

P.O. BOX 30026 LANSING, MICHIGAN 48909

CONTRACT CHANGE NOTICE

Change Notice Number 9 to

210000000214Contract Number

Various

Jeremy Lyon matt.goddard@volarisgroup.com

Matt Goddard

Canton, OH 44718

EVANS CASELOAD INC

CV0066977

905-271-4050

4450 Belden Village Street Suite 305

(517) 230-2858 S

T A

T E

P ro g n a g e r

C o n tra c t

A d m in is tra to r

C O

N T

R A

C T

O R

DTMB

lyonj5@michigan.gov

$1,141,396.69

December 15, 2020 December 14, 2025

MYCASELOAD ENHANCED DOCUMENT MANAGEMENT

April 11, 2025

INITIAL AVAILABLE OPTIONS EXPIRATION DATE

BEFORE

5 - 1 Year

PAYMENT TERMS DELIVERY TIMEFRAME

ALTERNATE PAYMENT OPTIONS EXTENDED PURCHASING

☐ P-Card ☐ PRC ☐ Other ☒ Yes ☐ No

MINIMUM DELIVERY REQUIREMENTS

DESCRIPTION OF CHANGE NOTICE

OPTION LENGTH OF OPTION EXTENSION LENGTH OF EXTENSION REVISED EXP. DATE

☐ ☐ December 14, 2025

CURRENT VALUE VALUE OF CHANGE NOTICE ESTIMATED AGGREGATE CONTRACT VALUE

$11,610.23 $1,153,006.92

Effective 4/5/2023, this change is to add pricing for the Document Packaging Module Subscription, Case Archiving Module Subscription for FY23 & FY24, this additional cost will be on the amount of $11,610.23. Please see attached invoice for further reference.

All other terms, conditions, specifications and pricing remain the same. Per contractor and agency agreement, and DTMB Central Procurement Services approval.

INITIAL EXPIRATION DATEINITIAL EFFECTIVE DATE

DESCRIPTION

Program Managers for

CHANGE NOTICE NO. 9 TO CONTRACT NO. 210000000214

Evans CaseLoad Inc.

2869 Bloor St W Suite 225 Toronto ON M8X 1B3 GST/HST Registration No.: 89100 2495 RT1

Estimate

ADDRESS

Michigan Office of Admin Hearings and Rules Attn: Julie A. McMurtry 611 W. Ottawa St., 2nd Floor Lansing MI 48933

ESTIMATE # 1024

DATE 02/03/2023

TAX ID

98-0199368

ACTIVITY QTY RATE AMOUNT TAX

Document Packaging Module Subscription (Apr 12, 2023 to Apr 11, 2024)

1 1,132.32 1,132.32 Exempt

Document Packaging Module Subscription (Apr 12, 2024 to Apr 11, 2025)

1 1,189.44 1,189.44 Exempt

Case Archiving Module Subscription (Sep 9, 2023 to Apr 11, 2024)

1 3,341.27 3,341.27 Exempt

Case Archiving Module Subscription (Apr 12, 2024 to Apr 11, 2025)

1 5,947.20 5,947.20 Exempt

These items will put the new licenses into sync with the existing licenses covered in contract 210000000214.

SUBTOTAL 11,610.23

TOTAL USD 11,610.23

Accepted By Accepted Date

Department of Technology, Management, and Budget

320 S. WALNUT ST., LANSING, MICHIGAN 48933

P.O. BOX 30026 LANSING, MICHIGAN 48909

CONTRACT CHANGE NOTICE

Change Notice Number 8 to

210000000214Contract Number

Various

Jeremy Lyon matt.goddard@volarisgroup,com

Matt Goddard

Canton, OH 44718

EVANS CASELOAD INC

CV0066977

905-271-4050

4450 Belden Village Street Suite 305

(517) 230-2858 S

T A

T E

P ro g n a g e r

C o n tra c t

A d m in is tra to r

C O

N T

R A

C T

O R

DTMB

lyonj5@michigan.gov

$1,141,396.69

December 15, 2020 December 14, 2025

MYCASELOAD ENHANCED DOCUMENT MANAGEMENT

April 11, 2025

INITIAL AVAILABLE OPTIONS EXPIRATION DATE

BEFORE

5 - 1 Year

PAYMENT TERMS DELIVERY TIMEFRAME

ALTERNATE PAYMENT OPTIONS EXTENDED PURCHASING

☐ P-Card ☐ PRC ☐ Other ☐ Yes ☒ No

MINIMUM DELIVERY REQUIREMENTS

DESCRIPTION OF CHANGE NOTICE

OPTION LENGTH OF OPTION EXTENSION LENGTH OF EXTENSION REVISED EXP. DATE

☐ ☐ December 14, 2025

CURRENT VALUE VALUE OF CHANGE NOTICE ESTIMATED AGGREGATE CONTRACT VALUE

$0.00 $1,141,396.69

Effective 4/5/2023, This change will reflect Language revisions to the Standard Contract Terms. Section 32.20. Administrative Fee and Reporting, and Section 32.21. Extended Purchasing Program, of the Standard Contract Terms, are removed and listed as Reserved in the contract. In addition, on the first page of the change notice, under Extended Purchasing, change the checked box from yes to no.

All other terms, conditions, specifications and pricing remain the same. Per contractor and agency agreement, and DTMB Central Procurement Services approval.

INITIAL EXPIRATION DATEINITIAL EFFECTIVE DATE

DESCRIPTION

Program Managers for

CHANGE NOTICE NO. 8 TO CONTRACT NO. 210000000214

Department of Technology, Management, and Budget

320 S. WALNUT ST., LANSING, MICHIGAN 48933

P.O. BOX 30026 LANSING, MICHIGAN 48909

CONTRACT CHANGE NOTICE

Change Notice Number 7 to

210000000214Contract Number

Various

Jeremy Lyon daevans@caseload.com

Darryl Evans

Toronto, ON M4C 1J5

EVANS CASELOAD INC

CV0066977

416-762-0236

1915 Danforth Avenue

(517) 230-2858 S

T A

T E

P ro g n a g e r

C o n tra c t

A d m in is tra to r

C O

N T

R A

C T

O R

DTMB

lyonj5@michigan.gov

$942,904.69

December 15, 2020 December 14, 2025

MYCASELOAD ENHANCED DOCUMENT MANAGEMENT

April 11, 2025

INITIAL AVAILABLE OPTIONS EXPIRATION DATE

BEFORE

5 - 1 Year

PAYMENT TERMS DELIVERY TIMEFRAME

ALTERNATE PAYMENT OPTIONS EXTENDED PURCHASING

☐ P-Card ☐ PRC ☐ Other ☒ Yes ☐ No

MINIMUM DELIVERY REQUIREMENTS

DESCRIPTION OF CHANGE NOTICE

OPTION LENGTH OF OPTION EXTENSION LENGTH OF EXTENSION REVISED EXP. DATE

☐ ☐ December 14, 2025

CURRENT VALUE VALUE OF CHANGE NOTICE ESTIMATED AGGREGATE CONTRACT VALUE

$198,492.00 $1,141,396.69

Effective 8/17/2022, the following change notice is to add funding for MOAHR for adding additional upgrades to myCaseLoad System. This change is in the amount of $198,492.00. Please see attached SOW below.

All other terms, conditions, specifications and pricing remain the same. Per contractor and agency agreement, and DTMB Central Procurement Services approval.

INITIAL EXPIRATION DATEINITIAL EFFECTIVE DATE

DESCRIPTION

Program Managers for

CHANGE NOTICE NO. 7 TO CONTRACT NO. 210000000214

Michael Weiszbrod 517-241-2928 WeiszbrodM@michigan.govDTMB

CONFIDENTIAL. DO NOT COPY. ©2022 CaseLoad Software. All Rights Reserved

July 19, 2022

Statement of Work Michigan Office of Administrative Hearings & Rules – 2022 Change Requests and Community Implementation

Introduction

This statement of work (SOW) is intended to provide details related to MOAHR’s request to implement changes to their instance of myCaseLoad in order to improve overall efficiencies with the current system. In addition, it will outline the implementation of the Community module to allow for electronic filing.

Project Summary

This project will involve the information gathering, configuration, testing, and packaging of system components to associated with the following:

No. Item Description

1 Archiving Module Automate archiving/deleting data from MCL that is past the retention schedule. Setup automated process for exporting attachments from MCL to a cheaper storage medium.

2 Interface adjustments to prevent people duplicates

Adjust the current intake interface to minimize the chance of duplicate people from being entered into myCaseLoad

Also, a script will be developed to be run against the…