Fulgent_2023_Renewal.doc.pdf
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- Contract number
- 505505-W22-SPB0005-00
- Issued by
- Wisconsin
About this file
This is Contract Amendment No. 1 to Contract #505505-W22-SPB0005-02 between the State of Wisconsin Department of Administration and Fulgent Therapeutics LLC, located at 4978 Santa Anita Ave, Temple City, CA 91780. The amendment was executed on August 29, 2022, and August 15, 2022, by the respective parties through their authorized representatives Cheryl Edgington, Director of State Bureau of Procurement for Wisconsin, and Jakub Sram for Fulgent Therapeutics.
The contract covers COVID-19 Testing and Analysis services. The amendment specifically modifies Section 3 of the original contract to extend the term structure, establishing that the initial contract term concludes on August 29, 2022, followed by an initial renewal period running from August 30, 2022, through August 29, 2023. The contract allows for commencement either upon the effective date of signature or later pursuant to an executed Purchase Order, with mutual written agreement between the parties as an alternative trigger mechanism. All other terms, conditions, rights, and obligations of the original contract remain unchanged except as specifically modified by this amendment.
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Text version
DocuSign Envelope ID: B650FFA5-5627-4423-80D6-C289E8F0B1FD DocuSign Envelope ID: 00638668-8DD6-4C86-A864-1BBFE26665B6
WISCONSIN DEPARTMENT OF ADMINISTRATION
DIVISION OF ENTERPRISE OPERATIONS
DOA-3051 (R 04/2019)
S. 51.01(5) WIS. STATS.; AND
S. 111.32(13M) WIS. STATS
STATE BUREAU OF PROCUREMENT
101 EAST WILSON STREET, 6TH FLOOR
POST OFFICE BOX 7867
MADISON, WI 53707-7867
FAX (608) 267-0600
TTY (608) 267-9629
HTTP://VENDORNET.STATE.WI.US
Contract Amendment
Contract No.: #505505-W22- SPB0005-02 Amendment No.: 1
Contract Title: COVID-19 Testing and Analysis
This Amendment is entered into by and between the State of Wisconsin, Department of Administration, and the Contractor, whose name, address and principal officer appears below.
Contractor Name Fulgent_Therapeutics_LLC
Contractor Address 4978 Santa Anita Ave
City: Temple City State: CA Zip: 91780
Principal Officer: James Xie
The parties wish to change the terms of the above-referenced Contract in the following manner:
Section 3 of the Contract is deleted and replaced in its entirety with the following:
3. TERM. The initial term of this Contract shall commence on the effective date of signature, or later pursuant to an executed Purchase Order (PO) or if mutually agreed between the Parties in writing, and the initial term will conclude on
8/29/2022. The Contract is renewed for an initial renewal from 8/30/22 and the initial renewal period will conclude on
8/29/2023.
Except as expressly changed by this Amendment, the terms, conditions, rights and obligations of Contract No.:
#505505-W22- SPB0005-02 shall remain in effect unchanged. In the event of any inconsistency or conflict in the Contract and this Amendment, the provision of this Amendment shall control.
To Be Completed by Contractor
For State of Wisconsin For Fulgent Therapeutics Department of Administration
Cheryl Edgington Company Name
Director, State Bureau of Procurement 4978 Santa Anita Ave
Address
Temple City
CA
91780
City State Zip
Signature By Jakub Sram
Printed Name
Date
8/15/2022 | 10:48 AM PDT
Signature
Jakub Sram
Title
8/15/2022 | 10:48 AM PDT
Date
This document can be made available in alternate formats to individuals with disabilities upon request.
DocuSign Envelope ID: 1571A2D3-D86A-42B2-8945-5057807F2513
8/29/2022 | 8:41 AM CDT
http://vendornet.state.wi.us/
| 2022-08-29T10:33:57-0700 | |
| Digitally verifiable PDF exported from www.docusign.com |
File details come from the government source that posted it. Updated .