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<br />~. -..y <br />~~ COTC PROCESSING FORM <br />~~-'~, AGREEMENTS AND AMENDMENTS <br />TO: CLERK OF THE COUNCIL OFFICE <br />FROM: DEPT.: C~1~~ <br /> <br />~.~. _ ~, , <br />MAIL STOP: 2-S <br />PROJECT MANAGER: j^.-~.? ,~ ~- ~,~~ Z EXT.: ,S yY.S- <br />THE FOLLOWING ITEMS NEED TO BE PROVIDED IN REQUESTING PROCESSING OF AGREEMENTS FOR.THE CITY: <br />AGREEMENT NUMBER (if amendment): A / N <br />AMENDMENT NUMBER (if applicable): SST ^ 2ND ^ 3RD ^ <br />NAME OF CONSULTANT: f-~.ir /d~t,i2~o ~~,,,,~. ~ //~ ~.___A <br />AMOUNT: OVER $25,000* (A) ^ UNDER $25,000v(N) <br />COUNCIL APPROVAL DATE: `Sr~1 D 5 ~ / y G9 ITEM #: ~~ € Z.5 /~ <br />TERM OF AGREEMENT- EFFECTIVE DATE: 7 ~ o TERMINATION DATE: <br />SIGNATURES REQUIRED: <br />^ VENDOR ^ AGENCY <br />^ CITY ATTORNEY ^ OTHER <br />(INSURANCE APPROVAL REQUIRED BY CAO PRIOR TO SUBMITTING TO COTC) <br />INSURANCE REQUIRED: ~ YES ^ NO (Provide City Attorney Office approval) <br />^ AUTO ^ CGL (Commercial General Liability) <br />^ PROFESSIONAL LIABILITY ^ WORKERS COMPENSATION <br />COMMENTS: ~. / -~ ~. ~;~, ~, ~1 / <br />FOR CLERK OFFICE USE ONLY: <br />^ PROCESS ^ DO NOT PROCESS <br />^ MISSING CONTACT/PROJECT MANAGER <br />INFORMATION <br />^ MISSING SIGNATURES <br />^ NEEDS COUNCIL APPROVAL <br />^ OTHER <br />ADDITIONAL REMARKS: ~ ~~ (~ ~ _ ~~3 ~ f~~~,F--1 <br />* (~har+nr aw.nr.rl.v..,..~ ,.cc-...~:, n_ <br />- -••-----•-~ ~---~~••...`~ ~ ~, ~~w w~ ~.ny manager COrlif'c~CL BULIIOCIL)/ InCI'@aS2. <br />