Laserfiche WebLink
CHECKLIST FOR PROCESSING AGREEMENTS AND AMENDMENTS <br />TO: CLERK OF THE COUNCIL OFFICE A <br />FROM: DEPT.: �,1-�S(C�� MAIL STOP: jy `_ 3(-p <br />CONTACT PERSON: KaQT -. QWZ, aliSE I d EXT.: SCS (6? <br />THE FOLLOWING ITEMS SHOULD BE PROVIDED IN REQUESTING PROCESSING OF AGREEMENTS FOR THE CITY: <br />AGREEMENT NUMBER (if amendment): A / N ZL/VL/ — t DV <br />AMENDMENT NUMBER (if applicable): ❑ 1 ST I ❑ 2"D ❑ 3RD ❑ <br />COUNCIL APPROVAL DATE: <br />AMOUNT: OVER $10,000 ❑ UNDER $10,000 <br />NAME OF CONSULTANT: + ,c��� 1✓G� > �_ <br />TERM OF AGREEMENT: EFFECTIVE DATE: — TERMINATION DATEO�l � <br />INSURANCE REQUIRED: NORLGD A , �W <br />YES If yes,�A4zPACHH D ❑ IN PROGRESS <br />❑ AUTO ❑ 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 ❑ <br />❑ CITY ATTORNEY ❑ <br />COMMENTS: <br />AGENCY (UNDER $10,000) <br />OTHER <br />FOR CLER OFFICE USE ONLY: <br />EV PROCESS ❑ DO NOT PROCESS <br />❑ MISSING SIGNATURES <br />❑ NEEDS COUNCIL. APPROVAL <br />❑ OTHER <br />ADDITIONAL REMARKS: <br />-vnW.oet <br />