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CHECKLIST FOR PROCESSING AGREEMENTS AND AMENDMENTS <br />TO: CLERK OF THE COUNCIL OFFICE <br />FROM: DEPT.: ex> I <br />STOP: M-� <br />CONTACT PERSON: t i��11 Cam{ EXT.: 5-4qO <br />THE FOLLOWING ITEMS SHOULD BE PROVIDED IN REQUESTING PROCESSING OF AGREEMENTS FOR THE CITY: <br />AGREEMENT NUMMBER-(tf amendment): A / N i)")1'1P.i'llirh"i- —f.) UGeVLSL <br />AMENDMENT NUMBER (if applicable): ❑ 1ST ❑ 2ND ❑ 3aD12 <br />COUNCIL APPROVAL DATE: <br />AMOUNT: ❑ O,V,,,,EIIR $10,000 ❑ UNDER $10,000 <br />U NAME OF CONSULTANT: l nyt S>fr4 f' --A. At-S-A. LLC, <br />TERM OF AGREEMENT: EFFECTIVE DATE: it-15-Q(e TERMINATION <br />4 <br />INSURANCE REQUIRED: ❑ NO J� hGTIV <br />❑ YES If yes, ❑ ATTACHED ❑ IN PROGRESS <br />❑ AUTO ❑ CGL (Commercial General Liability) <br />❑ PROFESSIONAL LIABILITY ❑ WORKERS COMPENSATION <br />(INS. APPROVAL REQUIRED BY CAD PRIOR TO SUBMITTING TO COTC) <br />SIGNATURES REQUIRED: <br />❑ VENDOR ❑ AGENCY (UNDER $10,000) <br />❑ CITY ATTORNEY /9- OTHER CMO, GOTG <br />COMMENTS: <br />FOR CLERK OFFICE USE ONLY: <br />❑ PROCESS DO NOT PROCESS <br />❑ MISSING SIGNATURES <br />NEEDS COUNCIL APPROVAL <br />g OTHER L <br />ADDITIONAL REMARKS: <br />/� ?6 -0'/ / tui/. &W&A202M -&i ,- 1940m!3ode <br />