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Qgu�at3on 1st <br />CHECKLIST FOR PROCESSING AGREEMENTS AND AMENDMENTS <br />TO: CLERK OF THE COUNCIL OFFICE <br />FROM: DEPT.: SIP ,,,�� MAIL STOP: ZD <br />CONTACT PERSON: Y/Iy1��G� 1�Y//��_ EXT.: Ti70 1'1 <br />THE FOLLOWING ITEMS SHOULD BE PROVIDED IN REQUESTING PROCESSING OF AGREEMENTS FOR THE CITY: <br />AGREEMENT NUMBER (if amendment): A / N <br />AMENDMENT NUMBER (if applicable): ❑ 1 ST ❑ 2ND El3RD ❑ <br />COUNCIL APPROVAL DATE:_ iO /7 & 5 - — <br />AMOUNT: Or OVER $10,000 ❑ UNDER $10,000 <br />NAME OF CONSULTANT: Ia/ 11/O/1 <br />TERM OF AGREEMENT: EFFECTIVE DATE:_( ���7/D5-- TERMINATION DATE: '/ _ - I <br />INSURANCE REQUIRED: ❑ NO /-%/ <br />l , L- 'gYES If yes, ❑ ATTACHED ❑ IN PROGRESS <br />n U• ❑ AUTO <br />❑ CGL (Commercial General Liability) <br />❑ PROFESSIONAL LIABILITY ❑ WORKERS COMPENSATION <br />(INS. APPROVAL REQUIRED BY CAO PRIOR TO SUBMITTING TO COTC) <br />SIGNATURES REQUIRED <br />❑ VENDOR ❑ AGENCY (UNDER $10,000) <br />❑ CITY ATTORNEY OTHER <br />COMMENTS <br />FOR CLERK OFFICE USE ONLY: <br />❑ PROCESS <br />ADDITIONAL <br />❑ DO NOT PROCESS <br />❑ MISSING SIGNATURES <br />❑ NEEDS COUNCIL APPROVAL <br />❑ OTHER <br />