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COTC PROCESSING FORM <br />D Agreements / Amendments / Deeds <br />TO: CLERK OF THE COUNCIL OFFICE <br />FROM: DEPT.: Santa Ana Police Department <br />PROJECT MANAGER: Commander Colon <br />N-2016-034 <br />MAIL STOP: M-97 <br />EXT.: x8410 <br />AGREEMENT NUMBER (if amendment): A / N <br />AMENDMENT NUMBER (if applicable): ❑ 1 ST ❑ 2ND F� 3RD ❑ <br />NAME OF CONSULTANT / PARTY: Community Service Programs (CSP) Sexual Assault Victim Services (SAVS) <br />AMOUNT: ❑ *OVER $25,000 —(A) m *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 />Approval. <br />® 1) NOT approved by council. <br />❑ 2) Approved by council. <br />COUNCIL APPROVAL DATE: <br />TERM OF AGREEMENT- EFFECTIVE DATE: <br />9-1-15 <br />ITEM #: <br />TERMINATION DATE: 8-31-18 <br />SIGNATURES REQUIRED: IT VENDOR © AGENCY <br />© CITY ATTORNEY ❑ OTHER <br />(INSURANCE APPROVAL REQUIRED BY CAO 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: MOU <br />DO NOT PROCESS <br />❑ Needs Council Approval <br />❑ Missing Signatures <br />❑ Other <br />R Charter amendment effective December 21, 2006 for City Manager contract authority increase; NS -2717 <br />OAgreements\Form - AGREEMENT PROCESSING FORM_canary.doc <br />Revised: 1/17/2012 <br />