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4,ducation jst <br />CHECKLIST FOR PROCESSING AGREEMENTS AND AMENDMENTS <br />TO: CLERK OF THE COUNCIL OFFICE <br />FROM: DEPT.: 4 J o v2E' <br />CONTACT PERSON: /� cc y �v r k <br />STOP: /N -(9 5— <br />Yi'% <br />THE FOLLOWING ITEMS SHOULD BE PROVIDED IN REQUESTING PROCESSING OF AGREEMENTS FOR THE CITY: <br />AGREEMENT NUMBER (if amendment): A / N A - Zoo 3 — 171 <br />AMENDMENT NUMBER (if applicable) <br />COUNCIL APPROVAL DATE:irl <br />AMOUNT:OVER $10,000 <br />NAME OF CONSULTANT: cle-6 <br />1141�1 ST ❑ 2ND ❑ 3RD ❑ <br />❑ UNDER $10,000 <br />TERM OF AGREEMENT: EFFECTIVE DATE: TERMINATION DATE: J-V�- 30 zeos— <br />INSURANCE REQUIRED: ❑ NO <br />)i, YES If yes, ❑ ATTACHEDIN PROGRESS <br />$,,., /AUTO CGL (Commercial General Liability) <br />Ler PROFESSIONAL LIABILITY !WORKERS COMPENSATION <br />(INS. APPROVAL REQUIRED BY CAO PRIOR TO SUBMITTING TO COTC) <br />SIGNATURES REQUIRED: <br />IT VENDOR ❑ AGENCY (UNDER $10,000) <br />CITY ATTORNEY )21� OTHER <br />COMM <br />FOR CLERK OFFICE USE ONLY: <br />PROC SS <br />ADDITIONAL REMARKS: <br />❑ DO NOT PROCESS <br />❑ MISSING SIGNATURES <br />❑ NEEDS COUNCIL APPROVAL <br />❑ OTHER <br />