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N - IOU -AD <br />_ COTC PROCESSING FORM <br />Agreements / Amendments / Deeds <br />Project Manager is responsible to ensure agreement has been <br />reviewed and approved by City Attorney, all exhibits attached, <br />Certificate of Insurance meets mandatory coverage, complies <br />with CMO contract authority as defined in NS-2963, and <br />ultimately, agreement is ready for City Manager execution. <br />COTC will o>lv be responsible for attestation of CMO signature. <br />TO: CLERK OF THE COUNCIL OFFICE <br />FROM: DEPT.: POLICE <br />PROJECT MANAGER: CMDR. VIR OWES, Please f.. Me.e.t dAGMT t. J.n.e C..ad <br />Clty of Santa Ana <br />APR 2 0 2021 <br />clerk 01 the Council <br />MAIL STOP: FISCAL M-97 <br />EXT.: 8700 <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): ❑ 1ST ❑ 2ND ❑ 3RD ❑ <br />An amendment/extension requires a copy of a RFCA / initial agreement IN Agreement) to be included. <br />NAME OF CONSULTANT / PARTY: ADLERHORST INTERNATIONAL, INC. <br />AMOUNT: ❑ * OVER ❑ *UP TO *Note: Council 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 />❑ 1) Approved by council. 0 2) NOT approved by council. <br />COUNCIL APPROVAL DATE: <br />TERM OF AGREEMENT EFFECTIVEDATE: 12/19/2020 <br />ITEM #: <br />TERMINATION DATE: 12/18/2022 <br />SIGNATURES REQUIRED: H VENDOR ❑ DIRECTOR N CITY MANAGER X COTC <br />M CITY ATTORNEY ❑ STATE/ GOV. AGENCY ❑ OTHER <br />(INSURANCE APPROVAL REVIEWED BY RISK MGMIT. PRIIOR TO SUBMITTING TO COTC) <br />INSURANCE REQUIRED: ❑ YES <br />ALL INSURANCE INCLUDED: 0 YES <br />NOTARIZATION REQUIRED: ❑ YES <br />COMMENTS: <br />FOR CLERK OFFICE USE ONLY: ❑ PROCESS <br />ADDITIONAL REMARKS: <br />* Effective April 18, 2019, City Managers contract <br />❑ NO (Provide City Attorney Office approval) <br />❑ NO <br />❑ NO <br />DO NOT PROCESS <br />❑ Missing Signatures ❑Needs Council Approval ❑ Other <br />I: IAgreementffwri -AGREEMENT PROCESSING FORM_canary_REVISED.doc Revised: 5/1512020 <br />