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COTC PROCESSING FORM <br />Agreements / Amendments / Deeds 15 gg <br />J Project Manager is responsible to ensure agreement has f 1 j) P I 9 <br />reviewed and approved by City Attorney, all exhibits attached, <br />Certificate of Insurance meets mandatory coverage, con-OlTsy OF SANTA ANA <br />with CMO contract authority as defined in NS-2963, ftcERK OF COUNCIL <br />ultimately, agreement is ready for City Manager execution. <br />COTC will onlv be responsible for attestation of CMO signature, <br />TO: CLERK OF THE COUNCIL OFFICE <br />FROM: DEPT.: CDA <br />PROJECT MANAGER: Terri Eggers <br />MAIL STOP: 25 <br />AGREEMENT NUMBER (if amendment): A / N Vz ollcf ' O `17 7>' ok <br />EXT.: 5378 <br />AMENDMENT NUMBER (if applicable): ❑ 1ST ❑ 2ND ❑ 3RD ❑ <br />NAME OF CONSULTANT / PARTY: ��lexy rib <br />AMOUNT: ❑ * OVER ❑ *UP TO `Note: Council approval is required if an agreement with a <br />$50,000 — (A) $50,000 - (AIN) vendor exceeds $50,000 within a Fiscal Year for non- <br />public works agreements. <br />Bid for contracts exceeding $25 000 will continue to <br />require a formal Invitation for Bid. <br />❑ 1) Approved by council. ❑ 2) NOT approved by council. <br />COUNCIL APPROVAL DATE: June 4, 2019 ITEM M 60 D <br />TERMOFAGREEMENT EFFECTIVEDATE: July 1, 2019 TERMINAT/ONDATE: June 30, 2020 <br />SIGNATURES REQUIRED: ❑ VENDOR ❑ AGENCY ❑ CITYATTORNEY❑ OTHER <br />(INSURANCE APPROVAL REQUIRED BY CAD PRIOR TO SUBMITTING TO COTC) <br />INSURANCE REQUIRED: ❑ YES ❑ NO (Provide City Attorney Office approval) <br />❑ AUTO ❑ CGL (Commercial General Liability) <br />❑ PROFESSIONAL LIABILITY ❑ WORKERS COMPENSATION <br />COMMENTS: <br />FOR CLERK OFFICE USE ONLY: ❑ PROCESS ❑ DO NOT PROCESS <br />❑ Missing Signatures ❑ Needs Council Approval ❑ Other <br />authority increased via Ordinance NS-2963. <br />IAAgreemenlfform -AGREEMENT PROCESSING FORM_canary_REVISED.doc Revised: 4/18/2019 <br />