85  FORM FIN1510-01 ForA Accounts Payable Use Only Vendor Number  GHORGL  CHECK REQUEST FORM  Uset thisf form to arrange forp payment to individuals orb businesses whena a Purchase Order orP P-card isr notr required.  This form must bes submittedi int typed format only.  Vendor Information Date 5/21/2024 Ifpayment ist toaVendor, isav W-9on file int the Purchasing Office? IFNo, a completed W-91 MUSTb be attached. Email MeaganF Porchi inc our Purchasing Division. MRERNSCAES  Vendor or Employee Name PayScale, Inc. 1-206-753-4038 Taxl ID: 91-1618647 Mailing Address (Check Payable to) P.O. Box 207845 Dallas, TX7 75320-7845 Email Address blings@pavscale.com  Talest  arcgement  MAV22/24A1  943  EXPENSE/ACCOUNT DETAILS  Description (for individuals, Services, Expense Reimbursements) Insight Lab Catalyze (Annual Subscription) (includes Survey Management, Strategy andl Market Analysis Invoice #150575  Dateof Service or  General Ledger Account  Amount $29,450.00  Invoice Fund Function Account Dept. 5/13/2024 100 1540 531100 06  Total Check Amount $29,450.00  DESCRIBE FULLY THE NATURE OF THE PAYMENT SIGNATURES/APPROVALS sppt  Note: For Extress Delivery-P PayScale, INc. 2975 Regent Blvd Ste 100, Iring, TX75063  Due Date: 6/12/2024 Dept,Designee Date uL ptt Staff Accopntant 5.Mail envelope)  Director ofF Finance Purchasing  Date Date Sendl Inter- Department Mail Wwillb bep placedinn mailboxa after2  /Date  spt  ana4 H : 0. 5.27.24  ww Vetoye  CHECK HANDLING INSTRUCTIONS 6.PitkUp-Approvalby! Finance Director  (Enclose attachments ifrequiredi inletters size Availablea attheF Finance Officer FrontD Deska after2 2:00p pme everyF Friday  AA  204-209  Please send this form with attachments to the Department of Finance. Each check request received Monday-Friday will be  processed the following Friday.    payscale. com E-mail: illing@payscale.com Fax:1( (206)299-3767 Phone: 1 (206)7 753- 4038 Tax ID# #:91-1618647  ipayscale  Invoice #150575 5/13/2024  BillTo Rockdale County 9581 Milstead Avenue Northeast Conyers georgia 30012 United States  ShipT To Rockdale County 9581 Milstead. Avenue Northeast Conyers georgia 30012 United States  TOTAL (USD)  $29,450.00  Due Date: 6/12/2024  Electronic funds transfer details: PayScale, Inc. Wells Fargo Bank, N.A. 420 Montgomery: Street San Francisco, CAS 94104 Account Number: 4941693327 Routing Number: 121000248  Make Checks Payable to: PayScale, Inc P.O. Box 207845 Dallas, TX75320-7845 USA  Pay with your Debit or Credit Card: ttps:lpayments.payscale.com  Terms Net30 ltem Catalyze Insight Lab Survey Management Strategy and Market Analysis Insight Lab  Due Date 6/12/2024  Contract Start Date 6/11/2022  Contract End Date 6/10/2025  Amount  Subtotal Total (USD) Amount Paid Amount Due  $29,450.00 $0.00 $29,450.00 $0.00 $29,450.00  Tax Total (Sales Tax 0%)  Allp payments are due ont the due date shown ont the Customer invoice. All past due and unpaid balances ares subject to collection. Int the evento of collection, customer willl bel liablef for costs of collectioni including attorney's fees, court costs, and collection agency fees.  1of1