MIKE PRLICH AND SONS, INC. (5) - Laserfiche WebLink

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SA T,A ANA CITY - R. CITY CLERK PROCESSING FORM _ * i' ~' ° 4f-I ,yk' Agreements /Amendments / Extensions / Deeds REVIVE FUNDED? COVID FUNDED? CONFIDENTIAL? ❑YES 11 NO ❑YES ❑� NO ❑YES 0 NO TO: CITY CLERKS OFFICE FROM: DEPT.: PWA / Water Resources MAIL STOP: M-85 PROJECT MANAGER: Leif Lovegren EXT.: 3327 The following information must be provided in requesting processing of agreements/amendments/extensions/deeds for the City: (See page 2 for instructions on how to fill out the this form) NAME OF CONSULTANT/ PARTY: MIKE PRLICH AND SONS, INC. AGREEMENT NUMBER (if applicable): A / N A-2024-165-01 AMENDMENT NUMBER El 1ST ❑ 2ND El 3RD ❑4TH (if applicable) : EXTENSION NUMBER ❑ 1ST ❑ 2ND ❑ 3RD ❑4TH (if applicable): An amendment/extension requires a copy of a Staff Report and/or initial agreement to be included. AMOUNT: * OVER El * $50,000 '"Note: Council approval is required if an agreement with a $ 0,000 AND UNDER vendor exceeds $50,000 within a Fiscal Year for non- public works agreements. Bid for contracts exceeding $50.000,will continue to reauire a formal Invitation for Bide ❑■ 1) Approved by council. ❑ 2) NOT approved by council. COUNCIL APPROVAL DATE: 10/15/24 ITEM#: 15 TERM OF AGREEMENT EFFECTIVE DATE: 10/15/24 TERMINATION DATE: 10/14/27 SIGNATURES REQUIRED: ❑ VENDOR ❑ AGENCY ❑ CITY ATTORNEY IN OTHER NOTARIZATION REQUIRED ❑ YES [X NO APPROVED INSURANCE: ❑ YES cV NO (INSURANCE APPROVAL REQUIRED BY RISK MGMT. PRIOR TO SUBMITTING TO CITY CILER/9 COMMENTS: �� Q f� 40.r des p X • (� FOR CLERK OFFICE USE ONLY: 0 PROCESS 0 DO NOT PROCESS ❑ Missing Signatures 0 Needs Council Approval 0 Qther _A JDDITIONAL REMARKS: (r15. - .D C2 *Effective July 6, 2023, City Manager contract authority increased via Ordinance NS-3041. I:\Agreements\Forms\Form-AGREEMENT PROCESSING FORM-06-19-2023-FINAL.doc Revised:06/19/2023 Page 1 of 2