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<br />~ <br />~ <br /> <br />CHECKLIST FOR PROCESSING AGREEMENTS ~Pnf'MENDMENTS <br />,e2/ Alf10:3 <br />TO: CLERK OFTHE COUNCILjOFFICE( CI) I <br /> <br />FROM: DEPT.: T:u - ! ,? - .' j CL. MAIL ST9~j![4'Z-6 <br />......--.." _.:? I ! <br />CONTACT PERSON: ~(.r -'-/--'..?r-,-r.J EXT.: -/- _.r <br />/.':; r <br /> <br />THE FOLLOWING ITEMS SHOULD BE PROVIDED IN REQUESTING PROCESSING OF AGREEMENTS FOR THE CITY: <br /> <br />AGREEMENT NUMBER (if amendment): A I N <br /> <br />AMENDMENT NUMBER (if applicable): <br />COUNCIL APPROVAL DATE: <br /> <br />o 1ST <br /> <br />o 2ND <br /> <br />o 3RD <br /> <br />o <br /> <br />~ UNDER $10,000 <br /> <br />NAME OF CONSULTANT: <br /> <br />o OVER $10,000 <br /> <br />5 vi AtJ J< <br /> <br />AMOUNT: <br /> <br />TERM OF AGREEMENT: EFFECTIVE DATE: <br />INSURANCE REQUIRED: X NO <br />o YES <br /> <br />)- \, ~3i <br /> <br />TERMINATION DATE: \ :<~I ~ J"'-' <br /> <br />If yes, 0 ATTACHED <br /> <br />o IN PROGRESS <br /> <br />o AUTO <br />o PROFESSIONAL LIABILITY <br /> <br />o CGL (Commercial General Liability) <br />o WORKERS COMPENSATION <br /> <br />(INS. APPROVAL REQUIRED BY CAO PRIOR TO SUBMITTING TO COTC) <br /> <br />SIGNATURES REQUIRED: <br />o VENDOR <br />o CITY ATTORNEY <br /> <br />o <br />o <br /> <br />AGENCY (UNDER $10,000) <br />OTHER <br /> <br />COMMENTS: <br /> <br />FOR CLE~FFICE USE ONLY: <br /> <br />d PROCESS . <br /> <br /> <br />DO NOT PROCESS <br />o MISSING SIGNATURES <br />o NEEDS COUNCIL APPROVAL <br />o OTHER <br /> <br />/,9-;1.'7.-06 -7 /fiIp,,/hV2.111 <br />I. <br /> <br />n <br /> <br />o <br /> <br />ADDITIONAL REMARKS: <br /> <br />~ ~ r:EJNL/n <br />fa, <br /> <br />. <br />