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COTC PROCESSING FORM <br />Agreements / Amendments / Deeds <br />TO: CLERK OF THE COUNCIL OFFICE <br />Cry <br />CITE' OF S,4--yi �i , r <br />CI..l:RK CIF- F;i`'t;l; <br />FROM: DEPT.: Parks, Recreation and Community Services Agency MAIL STOP: M-23 <br />PROJECT MANAGER: Silvia Cuevas <br />EXT.: 5254 <br />AGREEMENT NUMBER (if amendment): A / N <br />AMENDMENT NUMBER (if applicable): ❑ 1 ST ❑ 2ND n 3RD ❑ <br />NAME OF CONSULTANT / PARTY: Onmipoint Communications Inc. (Crown Castle, T -Mobile) <br />AMOUNT: ❑ *OVER $25,000—(A) m *UP TO $25,000 - (N) Note: If your agreement with a vendor exceeds $25,000 <br />within a Fiscal Year, then you will need to obtain Council <br />Approval. <br />1) NOT approved by council. <br />❑ 2) Approved by council. <br />COUNCIL APPROVAL DATE: N/A <br />TERM OF AGREEMENT- EFFECTIVE DATE: <br />2/26/15 <br />ITEM #: <br />TERMINATION DATE: <br />SIGNATURES REQUIRED: 7 VENDOR © AGENCY <br />[] CITY ATTORNEY © OTHER <br />N/A <br />(INSURANCE APPROVAL REQUIRED BY CAO PRIOR TO SUBMITTING TO COTC) <br />INSURANCE REQUIRED: ❑ YES QI NO (Provide City Attorney Office approval) <br />❑ AUTO ❑ CGL (Commercial General Liability) <br />❑ PROFESSIONAL LIABILITY ❑ WORKERS COMPENSATION <br />COMMENTS: Please notarize <br />Vendor is reauestino to make eauioment changes only. There is no visible impact to the site of tower. <br />*This is related to agreement A-2008-290 with OmniOoint Communications Inc. Site #LA03009C <br />DO NOT PROCESS <br />❑ Needs Council Approval <br />❑ Missing Signatures <br />❑ Other <br />* Charter amendment effective December 21, 2006 for City Manager contract authority increase; NS -2717 <br />1:1Agreements\Form -AGREEMENT PROCESSING FORM_canary.doc <br />Revised: 1/17/2012 <br />