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CITY ATTORNEY'S OFFICE M29 Checklist For Standard Consultant Agreement * *A COMPLETE CHECKLIST INCLUDES ALL INFORMATION CONTAINED ON THIS SHEET AND A COPY OF ALL EXHIBITS ** The following items should be provided in requesting preparation of agreements for the City: • AGREEMENT NUMBER A- • PROJECT MANAGER, MAIL STATION and EXT: TINA HORNER EXT. 8650 • CITY AGENCY: POLICE DEPT DIVISION: COMMUNICATIONS • COMMENCEMENT DATE OF CONTRACT OR CITY COUNCIL APPROVAL DATE • NAME & LEGAL CAPACITY OF CONSULTANT: Provide the full, correct name and the type of entity of the Other Party, e.g. a Delaware Corporation, a California General Partnership, an individual doing business as, etc. Name of Contracting Party: JUDY MERS, DIRECTOR OF GALA & SPECIAL EVENTS FOR BOWERS MUSEUM Legal Capacity of Contracting Party: INDIVIDUAL • SCOPE OF WORK/PROPOSALS: provide a short description of the work the consultant will be doing. E.g., "XYZ Co. is skilled in elevator repair services," or "provide the City with after - school training in square dancing." FACILITY & USE AGREEMENT FOR BOWERS MUSEUM ON APRIL 22ND, 2015 A 6- 8:30PM FOR S.A.P.D. ANNUAL EMPLOYEE AWARDS & RECOGNITION CEREMONY • TERM OF AGREEMENT: Provide ending dates or duration of contract from effective date. If renewals are provided for, what are the terms and conditions of the renewals? Please note: In general the City cannot contract for more than a single fiscal year without having, set aside the entire contract amount in the current fiscal year. Term: End of Fiscal Year End of Calendar Year x other (please provide) APRIL 22ND, 2015 6-8 PM • INSURANCE: Consultant will be required to carry City's standard insurance requirements and Additional Insured Endorsement (Exhibit B to standard agreement). Will professional errors and omissions coverage be needed? Professional Liability (E &0) Coverage Yes No • COMPENSATION: Is this a flat -fee contract or time and materials? What rates apply? Are expenses included or billed separately? What expenses are reimbursable? What is the maximum contract amount for services? What is the maximum amount for reimbursable expenses? FLAT ROOM RATE $330.00. Audio/Visual ASSISTANT $35.00 per hour, FOR 2 HOURS TOTAL FEES: $400.00 • PAYMENT SCHEDULE: Will there be milestones and progress payments? If so, what are the milestones, and what percent of the total contract amount is each progress payment? NO • NOTICES: To what address shall notices be sent to the consultant? Contact Person? FAX number? 2002 N MAIN ST. SANTA ANA, CA 92706 714/567 -3603 Fax number 71.4/567 -3623 Phone number JNlcr0a�bowers.orjL _ Emai] address • SIGNATORIES: What is the name and title of the individual(s) who will sign on behalf of the Other Party? If the Other Party is a corporation and the signatory is not a president, vice president or CEO evidence of the signatory's authority must be provided, either in the form of a resolution of the Board of Directors, attested by the corporate secretary, or in the form of a letter signed by the corporation's president, vice president, chief executive officer or corporate secretary. If the Other Parry is a partnership, the signature must be a general partner. Name THUY NGUYEN Its V.P. ADMINISTRATION /CHIEF FINANCIAL OFFICER (e.g., President, Chief Executive Officer, General Partner) • SPECIAL PROVISIONS: (ownership of work product, Please state any special provisions you want included in the contract. • DOES CONSULTANT HAVE ANY OTHER OPEN AGREEMENTS WITH THE CITY? If so, please list each contract and the amount: • ADDITIONAL REMARKS: