HomeMy WebLinkAboutCritical Mention Master summary 12.1.2023Certificate Of Completion
Envelope Id: C3F2371E937745A8A93B8704A360D8A4 Status: Completed
Subject: Complete with DocuSign: CM SOW- City of Oshkosh [Q-09888] (1).pdf
Source Envelope:
Document Pages: 9 Signatures: 5 Envelope Originator:
Certificate Pages: 5 Initials: 0 Laura Deutz
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-05:00) Eastern Time (US & Canada)
19 W. 44th Street
Suite 300
New York, NY 10036
ldeutz@criticalmention.com
IP Address: 67.245.22.202
Record Tracking
Status: Original
12/1/2023 3:31:44 PM
Holder: Laura Deutz
ldeutz@criticalmention.com
Location: DocuSign
Signer Events Signature Timestamp
Mark Rohloff
mrohloff@ci.oshkosh.wi.us
City Manager
City of Oshkosh
Security Level: Email, Account Authentication
(None)
Signature Adoption: Uploaded Signature Image
Using IP Address: 199.248.186.5
Sent: 12/1/2023 3:36:38 PM
Viewed: 12/1/2023 4:58:41 PM
Signed: 12/1/2023 4:59:07 PM
Electronic Record and Signature Disclosure:
Accepted: 12/1/2023 4:58:41 PM
ID: 3a3c6551-4d2b-4c90-8bb9-f3bb424fa740
Diane Barlett
dbartlett@ci.oshkosh.wi.us
Security Level: Email, Account Authentication
(None)
Signature Adoption: Uploaded Signature Image
Using IP Address: 199.248.186.5
Sent: 12/1/2023 4:59:09 PM
Viewed: 12/1/2023 5:20:44 PM
Signed: 12/1/2023 5:21:39 PM
Electronic Record and Signature Disclosure:
Accepted: 12/1/2023 5:20:44 PM
ID: a159dfc7-2390-4455-b570-c21e967b4769
Russ Van Gompel
rvangompel@ci.oshkosh.wi.us
Security Level: Email, Account Authentication
(None)
Signature Adoption: Uploaded Signature Image
Using IP Address: 199.248.186.5
Sent: 12/1/2023 5:21:40 PM
Viewed: 12/1/2023 5:22:23 PM
Signed: 12/1/2023 5:22:41 PM
Electronic Record and Signature Disclosure:
Accepted: 12/1/2023 5:22:23 PM
ID: f8a025fd-b2e4-4ab3-994d-59d152704fc8
Lynn Lorenson
llorenson@ci.oshkosh.wi.us
Security Level: Email, Account Authentication
(None)
Signature Adoption: Uploaded Signature Image
Using IP Address: 199.248.186.5
Sent: 12/1/2023 5:22:43 PM
Viewed: 12/1/2023 5:32:38 PM
Signed: 12/1/2023 5:33:01 PM
Electronic Record and Signature Disclosure:
Accepted: 12/1/2023 5:32:38 PM
ID: 8c0a04c8-6660-41ce-b209-e9aed986aa25
Signer Events Signature Timestamp
Zachary Jenkins
zjenkins@criticalmention.com
General Manager, North America
Critical Mention, Inc.
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 76.39.27.131
Signed using mobile
Sent: 12/1/2023 5:33:03 PM
Viewed: 12/1/2023 5:35:23 PM
Signed: 12/1/2023 5:35:36 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Iagree Iagree
iagree@criticalmention.com
Security Level: Email, Account Authentication
(None)
Sent: 12/1/2023 5:35:37 PM
Electronic Record and Signature Disclosure:
Accepted: 9/3/2021 11:36:12 AM
ID: 4fa707a0-aa2c-4f43-a2cd-122d4512a15e
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 12/1/2023 3:36:38 PM
Certified Delivered Security Checked 12/1/2023 5:35:23 PM
Signing Complete Security Checked 12/1/2023 5:35:36 PM
Completed Security Checked 12/1/2023 5:35:37 PM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, Critical Mention, Inc. (we, us or Company) may be required by law to
provide to you certain written notices or disclosures. Described below are the terms and
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any such documents from our office to you, you will be charged a $0.00 per-page fee. You may
request delivery of such paper copies from us by following the procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time
change your mind and tell us that thereafter you want to receive required notices and disclosures
only in paper format. How you must inform us of your decision to receive future notices and
disclosure in paper format and withdraw your consent to receive notices and disclosures
electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
and then wait until we receive back from you your acknowledgment of your receipt of such
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withdraw your consent using the DocuSign ôWithdraw Consentö form on the signing page of
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required notices and disclosures electronically from us and you will no longer be able to use your
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or to sign electronically documents from us.
All notices and disclosures will be sent to you electronically
Unless you tell us otherwise in accordance with the procedures described herein, we will provide
electronically to you through your DocuSign user account all required notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided or
made available to you during the course of our relationship with you. To reduce the chance of
you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process, please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
Electronic Record and Signature Disclosure created on: 1/31/2017 12:43:08 PM
Parties agreed to: Mark Rohloff, Diane Barlett, Russ Van Gompel, Lynn Lorenson, Iagree Iagree
How to contact Critical Mention, Inc.:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to: mbermann@criticalmention.com
To advise Critical Mention, Inc. of your new e-mail address
To let us know of a change in your e-mail address where we should send notices and disclosures
electronically to you, you must send an email message to us at mbermann@criticalmention.com
and in the body of such request you must state: your previous e-mail address, your new e-mail
address. We do not require any other information from you to change your email address..
In addition, you must notify DocuSign, Inc to arrange for your new email address to be reflected
in your DocuSign account by following the process for changing e-mail in DocuSign.
To request paper copies from Critical Mention, Inc.
To request delivery from us of paper copies of the notices and disclosures previously provided
by us to you electronically, you must send us an e-mail to mbermann@criticalmention.com and
in the body of such request you must state your e-mail address, full name, US Postal address, and
telephone number. We will bill you for any fees at that time, if any.
To withdraw your consent with Critical Mention, Inc.
To inform us that you no longer want to receive future notices and disclosures in electronic
format you may:
i. decline to sign a document from within your DocuSign account, and on the subsequent
page, select the check-box indicating you wish to withdraw your consent, or you may;
ii. send us an e-mail to mbermann@criticalmention.com and in the body of such request
you must state your e-mail, full name, IS Postal Address, telephone number, and account
number. We do not need any other information from you to withdraw consent.. The
consequences of your withdrawing consent for online documents will be that transactions
may take a longer time to process..
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Browsers (for SENDERS): Internet Explorer 6.0¬ or above
Browsers (for SIGNERS): Internet Explorer 6.0¬, Mozilla FireFox 1.0,
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Email: Access to a valid email account
Screen Resolution: 800 x 600 minimum
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** These minimum requirements are subject to change. If these requirements change, we will
provide you with an email message at the email address we have on file for you at that time
providing you with the revised hardware and software requirements, at which time you will have
the right to withdraw your consent.
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To confirm to us that you can access this information electronically, which will be similar to
other electronic notices and disclosures that we will provide to you, please verify that you were
able to read this electronic disclosure and that you also were able to print on paper or
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your future reference and access. Further, if you consent to receiving notices and disclosures
exclusively in electronic format on the terms and conditions described above, please let us know
by clicking the æI agreeÆ button below.
By checking the æI AgreeÆ box, I confirm that:
• I can access and read this Electronic CONSENT TO ELECTRONIC RECEIPT OF
ELECTRONIC RECORD AND SIGNATURE DISCLOSURES document; and
• I can print on paper the disclosure or save or send the disclosure to a place where I can
print it, for future reference and access; and
• Until or unless I notify Critical Mention, Inc. as described above, I consent to receive from
exclusively through electronic means all notices, disclosures, authorizations,
acknowledgements, and other documents that are required to be provided or made
available to me by Critical Mention, Inc. during the course of my relationship with you.