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<br />7-", <br />.."" <br />-/f <br />( . r~, I <br />,. .1 :2) <br />CHECKLIST FOR PROCESSING AGREEMENTS AND AMENDMENTS <br />, <br />, ' <br /> <br /> <br />TO: CLERK OF THE COUNCIL OFFICE <br />r <br />FROM: DEPT: t1 ti-A-I'tct <br /> <br />CONTACT PERSON: M. G,l-ll Z2..f <br /> <br />MAIL STOP: <br /> <br />Mlt <br />SOo'/? <br /> <br />EXT.: <br /> <br />THE FOLLOWING ITEMS SHOULD BE PROVIDED IN REQUESTING PROCESSING OF AGREEMENTS FOR THE CITY: <br /> <br />AGREEMENT NUMBER (il amendment): A I N <br /> <br />AMENDMENT NUMBER (il applicable): <br />COUNCIL APPROVAL DATE: <br />AMOUNT: 0 OVER $10,000 ~ UNDER $10,000 <br />NAME OF CONSULTANT: ()L'f t''If'I~vf mC;Ao:l't: AC&0?s CoNSJt-Ttt.{'l <br />TERM OF AGREEMENT: EFFECTIVE DATE: ~ 1<' lc't>b TERMINATION DATE: bE,e-' z tDo:J- <br /> <br />o 1ST <br /> <br />o 2ND <br /> <br />o 3RD <br /> <br />o <br /> <br />INSURANCE REQUIRED: 0 NO <br /> <br />~ YES II yes, f ATTACHED 0 IN PROGRESS <br /> <br />o AUTO )if CGL (Commercial General Liability) <br />p:r. PROFESSIONAL LIABILITY ~ 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 /> <br />OFFICE USE ONLY: <br />PROCESS <br /> <br />o <br /> <br />DO NOT PROCESS <br />o MISSING SIGNATURES <br />D NEEDS COUNCIL APPROVAL <br />D OTHER <br /> <br />ADDITIONAL REMARKS: /1/, rl ()06 - /'?.<:. <br />