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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. 0650 • CITY AGENCY: POLICE DEPARTMENT DIVISION: COMMUNICATIONS DATE OF CONTRACT OR CITY COUNCIL APPROVAL DATE • NAME & LEGAL CAPACITY OF CONSULTANT: Provide the frill, correct name and the type of entity of die Other Party, e.g, a Delaware Corporation, a California General Partnership, an individual doing business as, etc. Name of Contracting Party DOWERS MUSEUM, JUDY ME RS. DIRECTOR OF GALA AFFAIRS & EVENTS 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 "provides the City with afiemchool training in square dancing." • 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 with act amount in the current fiscal year. Term: _ End of Fiscal Year _ End of Calendar Year X Other (please provide) APRIL 27 2016 6:30-5:30 PM • INSURANCE; Consultant will be required to carry City's standard insurance requirements and Additional Insured Endorsement (Exhibit B to standard agreement). Will professional errom and omissions coverage be needed? Professional Liability (E&O) Coverage _ Yea _ 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? ROOM RATE $445.00 (SECURITY HOUSEKEEPING SETUP) & AUDIO VISUAL TTCHNrd — N• $120 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 SANTA ANA, CA 92705 714/567-3603(fax numbed 714/567-3623 CONTACT: JUDY MFRS; JMersLabowers.ora • 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 exemrtive offieer or corporate secretary. If the Other Party is a partnership, the signature must be a general partner. Name THUY NGLYEiN 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: r AGENCY COMMENCEMENT DATE AMOUNT I AUUI I IVIVAL KLIVIAKKS: