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2024-671-E-IT Dept-ESO Solutions-Software licensing and support for ESO application
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2024-671-E-IT Dept-ESO Solutions-Software licensing and support for ESO application
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Last modified
11/21/2024 9:32:11 AM
Creation date
11/21/2024 9:32:08 AM
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Contract
Date
11/1/2024
Contract Starting Date
11/1/2024
Contract Ending Date
11/4/2024
Contract Document Type
Contract
Amount
$9,000.00
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Please send payments to: ESO Solutions, Inc. PO Box 738310Dallas, TX 75373-8310 <br />Invoice <br />Date:10/8/2024 <br />Invoice #ESO-151991 <br />Terms Net 30 <br />Due Date 11/7/2024 <br />PO# <br />1 of 1 <br />Bill To Ship To <br />Orange County EMS - NC510 Meadowlands Drive PO Box 8181Hillsborough NC 27278United Statessensenat@orangecountync.gov <br />Orange County EMS - NC510 Meadowlands Drive PO Box 8181HillsboroughNC 27278US <br />Item From To QTY UOM List Amount Discount Total <br />Billing - Patient Care Report Import <br />Automated ePCR import. <br />9/29/2024 9/28/2025 30,000 Claims USD $1,546.31 USD $1,546.31 USD $0.00 <br />Billing Software Subscription <br />Includes unlimited user licenses, support, software updates and maintenance. Automated ePCR import, mileage verification calculator, automated <br />cash posting and auto crosswalk and reporting tool comes standard. <br />9/29/2024 9/28/2025 15,000 Claims USD $13,128.62 USD $1,312.87 USD $11,815.75 <br />Invoice Message: <br />ACH/EFT bank information: JP Morgan ChaseRouting: 111000614Account Number: 577211926 <br />Check Remittance lockbox address: ESO Solutions, Inc. PO Box 738310Dallas, TX 75373-8310 <br />Total (Without Tax):USD $11,815.75 <br />Tax:USD $0.00 <br />Grand Total:USD $11,815.75 <br />Amount Paid/Credit:USD $0.00 <br />Total Recurring:USD $11,815.75 <br />Total One-Time: <br />Invoice Balance:USD $11,815.75 <br />Please submit payment remittances to accountsreceivable@eso.com to ensure correct invoice application. <br />Amounts invoiced are per your agreement(s) which may include annual uplift and an increase in quantities based on usage overages. Your payment of this invoice serves as acceptance of such increases. <br />Questions? Contact: AccountsReceivable@eso.com 866-766-9471 option 8 <br />Tax ID: 36-4566209 <br />ESO will never e-mail you soliciting payment information. Please call us or e-mail AccountsReceivable@eso.com if you have any questions or wish to make a change. <br />This invoice presents the total net price of the product(s) and/or service(s) which is inclusive (net) of any discount. As the buyer of such product(s)/service(s), you may have additional reporting obligations to federal or state health care programs (including pursuant to 42 CFR 1001.952(h)) and/or upon inquiry by the HHS Secretary or other state or federal agencies. As the buyer, you must adhere to any other relevant federal or third-party payer requirements. <br />For a 3% fee, pay via Card <br />Direct Card Payment Link: https://app.suitesync.io/payments/acct_1FelgtGvY2g6ha8S/custinvc/7833773/?amount=1217022.25 <br />Pay via Online Bank Transfer <br />Direct Bank Transfer Link: https://app.suitesync.io/payments/acct_1FelgtGvY2g6ha8S/custinvc/7833773/?card=false <br />Docusign Envelope ID: EEDF8BAE-5C17-4977-94BB-7031A1A422BA
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