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COTC PROCESSING FORM <br />Agreements and amendments <br />k kt ^wv.:, �s�2 <br />TO: CLERK OF THE COUNCIL OFFICE <br />FROM: DEPT.: Public Works - Design Engineering <br />PROJECT MANAGER: Jason Gabriel <br />AGREEMENT NUMBER (if amendment): A / N Easement Deed <br />AMENDMENT NUMBER (if applicable): ❑ 1ST ❑ 2ND ❑ 3RD <br />NAME OF CONSULTANT: County of Orange <br />C;T., <br />Ak1 !Q- 25 <br />MAIL STOP:$ <br />EXT.: 5664 <br />AMOUNT: ❑ * OVER $25,000 -D(A) El *UP TO $25 000 - (N) <br />V1E'- 1<'PcY _ PJotn 'Pyovr a grou rir nt ..tiNIi a venrlcirr, rxc ,d's uv t ,jr= a ri;,ca <br />ihonyou wdI nced to obtai,r t €ainti° Apix0 v'' <br />COUNCIL APPROVAL DATE: /o Ig y / 0 ITEM #: <br />TERM OF AGREEMENT- EFFECTIVE DATE: <br />TERMINATION DATE: <br />SIGNATURES REQUIRED: ❑ VENDOR ❑ AGENCY <br />0 CITY ATTORNEY IV] OTHER <br />(INSURANCE APPROVAL REQUIRED BY CAD PRIOR TO SUBMITTING TO COTC) <br />INSURANCE REQUIRED: ❑ YES 0 NO (Provide City Attorney Office approval) <br />❑ AUTO ❑ CGL (Commercial General Liability) <br />❑ PROFESSIONAL LIABILITY ❑ WORKERS COMPENSATION <br />COMMENTS: If Jason Gabriel is not available, please contact Carlos Castellanos (x5642). <br />CLERK OFFICE USE ONLY: <br />❑ PROCESS ❑ DO NOT PROCESS <br />❑ Needs Council Approval <br />❑ Missing Signatures <br />❑ Other <br />ADDITIONAL REMARKS: <br />" Charter amendment effective December 21, 2006 for City Manager contract authority increase; NS-2717 <br />I. Agreements\Form- AGREEMENT PROCESSING FORM_canary_10-26-10.tloc <br />