CM-2022-321 - 12/16/2022 DocuSign Envelope ID:607988C3-1320-4080-13424-9EIC0050064C
City of Round Rock - 0492,166
�k_ir)AuSTIN
COMMUrff" SPONSORSHIPAGREEMENT
NITY 9 101 Tuscany Way,Austin,TX 78754
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CLLEGE
C> 1STRICT
Austin Community College District("ACC")requires all sponsors to abide by the following conditions,and
reserves the right to cancel this agreement for the failure of a sponsor to follow these conditions,
1. Modifications to this agreement are not allowed.
2. Please submit this agreement via email to AccSpons@austincc.edu.
3. This form must be submitted before the initial payment deadline or the student(s)will be dropped.
4, Any refunds due from sponsor payments will be remitted to the sponsor.
S. Tuition and fees are assessed based on the student's residency,not the sponsor's address.
6. The sponsor agrees not to restrict payment based on the student's attendance or grades. Any payment
dispute due to the student's non-compliance with the sponsor's conditions shall be resolved by the
sponsor and the student.
7. The sponsor agrees to pay ACC within thirty(30)days of the invoice dale or the sponsor's account will be frozen and no
additional agreements will be accepted,
8. This agreement is valid for the current fiscal year,
9. In accordance with the Family Education Rights and Privacy Act(lq,-RPA)of 1974,student
information will not be release without a signed sponsorship student agreement.See attached form.
The following information is required for all sponsorship agreements:
I. The student's name and ACC ID number or the last four digits of the student's social security number.
2. Course information and Section Number,
3. Information must be received in accordance to format provided.See Sponsorship Student Detail information.
4. Amount to be paid on behalf of the student.
a. If the sponsor does not cover the total amount due,any unpaid balance will be the student's responsibility,
b. Any unpaid balance may result in the dropping of all courses in which the student is registered.
5. Please select one of the following for the courses listed on the Sponsorship Student Detail Information spreadsheet:
EZ All Tuition and Fees
D All Tuition
0 Fixed Amount:
L1 Percentage ofCost:
Billing/Sponsor Information:City of Round Rock Invoice W] or Payment in AdvanceED
Primary Contact Person:Valede Francois Primary Email Address.vfrancois@roundrocktoxes,gov
Billing Address: 221 East Main Street City:Round Rook State:TX
Primary Phone Number: (512)218-5494 Zip:78664
I agree to the above conditions or have the authority to bind my company to the above conditions:
5 CCUSig nod by:
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Authorized Sponsor Signature Austin Community Co lege District
Laurie Hadley,City Manager John Zehr
Print thorized Signer's Name Print Authorized Signer's Name
1/4/2023
Date U Date
(512)218-5401 john.zehr@austincc,edu
Phone Number(including area code) Email Address
ACC Sponsorship 1 •
Bill to Pay (B2P) Process Flowchart
The sponsor or,SCC coorduralor con;.ie(s
fl2P to set up a netiv sponsorship
agreement
RE4UIRED H2P sends the sponsorship packet to the REQUIRED
sponsor or ACC coordinator.The packet
ACC students must complete an must be retuned S business days before the sponsor must send the FEHPA Waiver
FEHPA vlaiver Forrn the initial payment deadline Form for their crnployees to B2P
Will the sponsor+equip'an invnic�>
bi•fnre rhe payment is rtrn i7 kt'rF?
The sponsor will send ACC the amount
R7P dill invoice the sponsor due 9tc(ore the first riay of t1u55
The sponsor pays[he invoice fl2P Shall trCatc a sponsorship account to
{.Vet 30) track the(undlni;
'i he payment is applied to sponsor's ACC prov�dc5lhe sponsor wit}ti a
account statement sho,rurg the account�alancr
Should t}tere be any adds or drops, tVhonthcspoersor'saccountisclabcd,
R2P will send an additional invoice
or a refund to the sponsor
hCC trig refund the remaining balance
City of Round Rock
+ ROU ROCK
TEXA5 Agenda Item Summary
Agenda Number:
Title: Consider executing a Sponsorship Agreement with Austin Community College for
payment of tuition and fees.
Type: City Manager Item
Governing Body: City Manager Approval
Agenda Date: 12/16/2022
Dept Director: Valerie Francois
Cost:
Indexes:
Attachments: New Sponsor Agreement Package MOU ACC
Department: Human Resources
Text of Legislative File CM-2022-321
Sponsorship Agreement with Austin Community College for payment of tuition and fees.
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