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<br />N - 200 G -\ I 7 <br /> <br />o <br />-,' ~ <br />@) '-7 C' {i/c <br />11Jl!, [:fr, 2 \ /,1'\ g. '3 CjJJ/ /.9 <br />" .' \'\~ {'; ~.P.- . <br />CHE~KLIST FORPFtOCESSING AGREEMENTS AND~JIIIE.Nd8IENTS <br />, /., A,I" <br />vi>;n"i'A <br />v'Z "t <br /> <br /> <br />FROM: <br /> <br />CLERK OF THE COUNCIL OFFICE <br />DEPT.: S~ '(\~f\. ('AT'J ~1Il\L <br />CONTACT PERSON ~{\l'\0I tS-Ho..do. <br /> <br />MAIL STOP: H..c;<( <br />EXT t.12.l.P <br /> <br />TO: <br /> <br />THE FOLLOWING ITEMS SHOULD BE PROVIDED IN REQUESTING PROCESSING OF AGREEMENTS FOR THE CITY: <br />AGREEMENT NUMBER (if amendment): A / ~ -1.00~' 0<-14 (Ol.t> "'l.\fr\~ \ <br /> <br />AMENDMENT NUMBER (if applicable): 0 1ST <br />COUNCIL APPROVAL DATE: Sevy 'Lb,1S:f:L" <br />AMOUNT: 0 OVER $10,000 0( UNDER $10,000 <br />NAME OF CONSULTANT~"'l'"\-\-~ ~'i:.l)-tJ <br />TERM OF AGREEMENT: EFFECTiVE DATE:-.)PrN \. '!DO(, TERMINATION DATE:~ 5\ :ZOC~ <br /> <br />o 2ND <br /> <br />o 3RD <br /> <br />o <br /> <br />INSURANCE REOUIRED: 0 NO <br />"&. YES <br /> <br />If yes, 0 ATTACHED <br /> <br />'c3. iN PROGRESS <br /> <br />o AUTO <br />o PROFESSIONAL liABiliTY <br /> <br />o CGL (Commercial General Liabliity) <br />o WORKERS COMPENSATION <br /> <br />(INS. APPROVAL REQUIRED BY CAO PRIOR TO SUBMITTING TO COTC) <br /> <br />SIGNATURES REOUIRED: <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 />1.1 -19 -0 (, rJ/i:t. <br />ADDITIONAL REMARfl:S: h9?'J <br />'Y' <br />/rJ.- 7 Df.~'i <br /> <br /> <br />? <br /> <br />FOR CLER'59FFICE USE ONLY: <br />~ PROCESS <br /> <br />,m <br />