Axon_Ex._D-Quarterly_Activity_Report.xlsx.pdf
PDF 323 KB Posted
- Attached to
- *EXPIRED* NASPO Public Safety Video Systems
- Contract number
- *EXPIRED* 505ENT-O18-SAFETYVIDEO-00
- Issued by
- Wisconsin
About this file
This document is a quarterly sales report template for the NASPO ValuePoint Cooperative Contract for Public Safety Video Systems, Contract #505ENT-O18-SAFETYVIDEO-04, involving Axon (formerly known as Taser) as the manufacturer. The report is specifically designed for Wisconsin's participation in this multi-state cooperative agreement and must be submitted to Wisconsin's primary state government contact for all Wisconsin purchases under the contract.
The contract covers public safety video systems and related equipment, with quarterly reporting requirements that include detailed purchase information such as agency names, contact details, purchase order numbers and dates, product descriptions, contract item numbers, quantities, list prices, contract rates, and total spend amounts. Reports must be submitted according to a specific calendar quarter schedule with due dates of October 31, January 31, April 30, and July 31. The document includes a sample entry showing the Department of Corrections purchasing 2 units of item XYZ for $100 each (contract rate) versus a $150 list price, resulting in $100 total spend and $50 in savings. Failure to submit timely reports in the required format may result in suspension of the agreement, and reports are required even when there is no purchasing activity during the quarter.
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Text version
NASPO ValuePoint Cooperative Contract Sales Report
Summary for Public Safety Video Systems, Contract #505ENT-O18-SAFETYVIDEO-04
Manufacturer Name: Axon (Formerly Known As Taser)
Calendar Quarter 1 (July 1 to September 30)
Calendar Quarter 2 (October 1 to December 31)
Calendar Quarter 3 (January 1 to March 31)
Calendar Quarter 4 (April 1 to June 30)
Due October 31
Due January 31
Due April 30
Due July 31
Agency Name
Agency Contact Name
Agency Address
Agency Telephone Number
Purchase Order Number
Purchase Order Date
Type of lab supply Provided
Total Purchase Order Amount
Total Dollars for the quarter
Contractor shall submit reports to the Wisconsin Participating Agreement primary state government contact (or designee) for all Wisconsin purchase(s) providing the following information:
A report is due even when there is no activity. Any report that does not follow the required format or excludes information will be deemed incomplete.
Failure to submit reports on a timely basis may constitute grounds for suspension of this agreement. Reports will be submitted in accordance with the following schedule:
Axon Exhibit D - Quarterly Activity Report (Sales Report)
DocuSign Envelope ID: 8731AECE-EEF6-4A24-8DC2-407BC67A849BDocuSign Envelope ID: 478326E2-3E8B-4176-92BC-BB4E7A710CC7
NASPO ValuePoint Cooperative Contract Sales Report
Summary for Public Safety Video Systems, Contract #505ENT-O18-SAFETYVIDEO-04
Manufacturer Name: Axon (Formerly Known As Taser)
Report Start date:
Report End Date:
Today's Date:
State or
Municipality
Agency
Name
Agency
Contact
Name
Agency
Address
City Agency
Telephone
Number
Purchase
Order
Number
Purchase
Order
Date
Contract
Band
Item
Description
Contract
Item
Number
Unit of
Measure
Qty List Price Contract
Price/Rate
Total
Spend
Total Spend -
Savings (Extended
List Price less
Contract Rate)
Department of
Corrections
Mary Johnson 123 Johnson St., Madison 608-123-1234 123456 11/10/2020 1 XYZ 123 EA 2 150 100 100 $50
Note to Preparer: Sample data is in red. Remove the sample data on the submitted electronic report.
Axon Exhibit D - Quarterly Activity Report (Sales Report)
DocuSign Envelope ID: 8731AECE-EEF6-4A24-8DC2-407BC67A849BDocuSign Envelope ID: 478326E2-3E8B-4176-92BC-BB4E7A710CC7
| 2021-03-09T17:11:12-0800 | |
| Digitally verifiable PDF exported from www.docusign.com |
File details come from the government source that posted it. Updated .