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COTC PROCESSING FORM <br />Agreements / Amendments / Deeds <br />Project Manager is responsible to ensure agreement has been Zr� tIOV 27 �� io= 27 <br />reviewed and approved by City Attorney, all exhibits attached, <br />Certificate of Insurance meets mandatory coverage, compliesC)rY OF SANTA ANA <br />with CMO contract authority as defined in NS-2963, and uLL?; OF COUNCIL <br />ultimately, agreement is ready for City Manager execution. <br />COTC will only be responsible for attestation of CMO signature. <br />TO: CLERK OF THE COUNCIL OFFICE <br />FROM: DEPT.: Human Resources <br />MAIL STOP: 24 <br />PROJECT MANAGER: C)ndl Sa►1genito EXT.: 5374 <br />The following information must be provided <br />in requesting processing of agreements / amendments / deeds for the City: <br />AGREEMENT NUMBER (if amendment): A / N <br />AMENDMENT NUMBER (if applicable): ❑ 1 ST ❑ 2ND ❑ 3RD ❑ <br />NAME OF CONSULTANT / PARTY: SE I U <br />AMOUNT: 0 * OVER Note: Council ❑ *UP TO � approval is required if an agreement with a <br />$50,000 — (A) $50,000 - (A/N) 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 />0 1) Approved by council. ❑ 2) NOT approved by council. <br />COUNCIL APPROVAL DATE: 1 1 /1 9/ZO 1 9 ITEM #: ZOD <br />TERM OF AGREEMENT EFFECTIVE DATE: 7/1 /ZO 19 TERMINATION DATE: 6/30/2022 <br />SIGNATURES REQUIRED: ❑ VENDOR X AGENCY ❑ CITY ATTORNEY ❑ OTHER <br />(INSURANCE APPROVAL REQUIRED BY CAO PRIOR TO SUBMITTING TO COTC; <br />INSURANCE REQUIRED: ❑ YES ❑ NO (Provide City Attorney Office approval <br />❑ AUTO ElCGL (Commercial General Liability) ) <br />❑ PROFESSIONAL LIABILITY ❑ WORKERS COMPENSATION <br />COMMENTS: <br />I:V,greementslForm -AGREEMENT PROCESSING FORM_canary_REVISED. doc <br />Revised: 4/18/2019 <br />