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Contact Information <br />Organization <br />URL <br />Street Address <br />Address 2 <br />City State <br />Postal Code <br />CivicPlus provides telephone support for all trained clients from 7am —7pm Central Time, Monday -Friday (excluding holidays). <br />Emergency Support is provided on a 24/7/365 basis for representatives named by the Client. Client is responsible for <br />ensuring CivicPlus has current updates. <br />Emergency Contact & Mobile Phone <br />Emergency Contact & Mobile Phone <br />Emergency Contact & Mobile Phone <br />Billing Contact <br />E-Mail <br />Phone Ext. <br />Fax <br />Billing Address <br />Address 2 <br />City State <br />Postal Code <br />Tax ID # <br />Sales Tax Exempt # <br />Billing Terms <br />Account Rep <br />Info Required on Invoice (PO or Job #) <br />Are you utilizing any external funding for your project (ex. FEMA, CARES): Y [ ] or N [ ] <br />Please list all external sources: <br />Contract Contact Email <br />Phone Ext. Fax <br />Project Contact Email <br />Phone Ext. Fax <br />Page 4 of 4 <br />30 <br />