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R x <br />USH <br />rt Al 2016.008 <br />COTC PROCESSING FORM���� <br />Agreements / Amendments / Deeds ?1313 'll'ti dap try: <br />CITY ()F SANI <br />CLERK < <br />i), <br />TO: CLERK OF THE COUNCIL OFFICE rt <br />FROM: DEPT.: I OL, CG / l MAIL STOP: -1 —) <br />PROJECTMANAGER: �r Ply" �OLp`� EXT.: e,�41 0 <br />AGREEMENT NUMBER (if amendment): A / N <br />AMENDMENT NUMBER (if applicable): ❑ 1ST ❑ 2ND ❑ 3RD ❑ <br />NAME OF CONSULTANT / PARTY: H LAvrnAj O m o ojs <br />AMOUNT: ❑ * OVER $25,000 - (A) [( *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 />,-J -,/ Approval. <br />L r) NOT approved by council. <br />❑ 2) Approved by council. <br />1Ki1111[ ]I W:1>11.10IT /11gJ:1111114 <br />TERM OF AGREEMENT- EFFECTIVE DATE: 10 1// 1& <br />SIGNATURES REQUIRED: ❑ VENDOR <br />❑ CITYATTORNEY <br />ITEM #: <br />TERMINATION DATE: C113 D J I9 <br />❑ AGENCY <br />❑ OTHER <br />(INSURANCE APPROVAL REQUIRED BY CAD 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: Ucy^+- G y-av�`Ir- orlon c4u,2 `toant J Q Yvyckk no� -. <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 />