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<br /> <br />'J~-., <br />, <br /> <br />! ~ <br /> <br />, ':t C/. If <br />CHECKLIST FOR PROCESSING AGREEMENTS ANDAMENDMENTSu <br /> <br />TO: CLERK OF THE COUNCIL OFFICE <br /> <br />FROM: DEPT.: <br /> <br />j>WA - T/2AI=FIC <br /> <br />CONTACT PERSON: <br /> <br />c ~,..q/2 !!O/)Il/6'lJc-z... <br /> <br />MAIL STOP: '-/-4 E> <br /> <br />EXT.: ~h 2 b <br /> <br />AGREEMENT NUMBER (if amendment): A I N <br /> <br />THE FOLLOWING ITEMS SHOULD BE PROVIDED IN REQUESTING PROCESSING OF AGREEMENTS FOR THE CITY: <br /> <br />AMENDMENT NUMBER (if applicable): <br />COUNCIL APPROVAL DATE: <br /> <br />o 1ST <br /> <br />o <br /> <br />o 2ND <br /> <br />o 3RD <br /> <br />AMOUNT: <br />NAME OF CONSULTANT: <br /> <br />DOVER $10,000 <br /> <br />Bl:JNDER $10,000 <br /> <br />!/J1lvCYfl+Y t'-Il4'klwJ1I;"~ BdJ"".,fe./C.Y <br /> <br />TERM OF AGREEMENT: EFFECTIVE DATE:~'4'l 2'1 c~7 TERMINATION DATE: F,- h (. Vj <br />, <br /> <br />INSURANCE REQUIRED: ~O <br /> <br />DYES <br /> <br />If yes, 0 ATTACHED <br /> <br />o AUTO <br />o PROFESSIONAL LIABILITY <br /> <br />o IN PROGRESS <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 />iY VENDOR <br />G" CITY ATTORNEY <br /> <br />~ AGENCY (UNDER $10,000) <br />g..- OTHER <br />C~/T'r. UA/lUAGtJe..) <br /> <br />COMMENTS: <br /> <br />FOR CLERK OFFICE USE ONLY: <br />~PROCESS <br /> <br />o <br /> <br />DO NOT PROCESS <br />o MISSING SIGNATURES <br />rJ NEEDS COUNCIL APPROVAL <br />o OTHER <br /> <br />ADDITIONAL REMARKS: / - /1- 0 <br /> <br /> <br />