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N7 <br /> CITY CLERK PROCESSING FORM <br /> Agreements /Amendments / Extensions / Deeds <br /> REVIVE FUNDED? COVID FUNDED? CONFIDENTIAL? <br /> [] YES 9 NO [I YES A NO 0 YES 9 NO <br /> TO: CITY CLERK'S OFFICE <br /> FROM: DEPT.: Public Works - Parks, Fleet, Facilities, and Refuse MAIL STOP: M-1 1 <br /> - <br /> PROJECT MANAGER. Phil Neff/Michelle Cabanas EXT.. 3554 <br /> The following imbirmation must be provided <br /> in requesting processing of agreements/amendments/extensions/deeds for the C itf. <br /> (See page 2 for instructions on how to fill out the this form) <br /> NAME OF CONSULTANT I PARTY: BNS Construction K <br /> AGREEMENT NUMBER (if applicable): A / N <br /> AMENDMENT NUMBER 0 1ST 0 2ND El 3RD El 4TH <br /> (if applicable) : <br /> EXTENSION NUMBER El 1ST El 2ND I-] 3RD El 4TH <br /> (if applicable): <br /> An amen dme ntlextensi on requires a copy of a Staff Report and/or initial agreement to be included. <br /> AMOUNT: N * OVER El * s5o,o00 *Note: Council approval is required if an agreement with a <br /> $50,000 AND UNDER vendor exceeds $50,000 within a Fiscal Year for non- <br /> public works agreements. <br /> Bid for contracts exceediag-150,000, will continue to requirea formal Invitation for Bid. <br /> 1) Approved by council. El 2) NOT approved by council. <br /> COUNCIL APPROVAL DATE: 04-01-2025 ITEM#: 17 <br /> TERM OF AGREEMENT EFFECTIVE DATE: 04-01-2025 TERMINATION DATE: N/A <br /> SIGNATURES REQUIRED: El VENDOR El AGENCY El CITY ATTORNEY H OTHER <br /> NOTARIZATION REQUIRED Ll YES 5011 NO <br /> APPROVEDINSURANCE: N YES F-1 NO <br /> (INSURANCE APPROVAL REQUIRED BY RISK MGMT. PRIOR TO SUBMITTING TO CITY CLERK) <br /> COMMENTS: Please contact Marisol for pick-up at x5663 <br /> Please send physical copies to Hortencia Martinez M-1 1 _fAAZboo 0(1 me <br /> FOR CLERK OFFICE USE ONLY: 0 PROCESS 0 DO NOT PROCESS <br /> 0 Missing Signatures 0 Needs Council Approval 0 Other <br /> ADDITIONAL REMARKS: c1L t,4 0)"601................ <br /> ----------- .................... <br /> *Effective July 6, 2023, City Manager contract authority increased via Ordinance NS-3041. <br /> 1:IAgreements\Formfform-AGREEMENT PROCESSING FORM-06-19-2023-FINAL.doc Revised:06/1912023 <br /> Page 1 of 2 <br />