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t') <br />G6TC PROCESSING FORM <br />Agreements / Amendments / Deeds <br />TO: CLERK OF THE COUNCIL OFFICE <br />FROM: DEPT.: Design Engineering <br />PROJECT MANAGER: Mindv Lv <br />V16 QCT 31 h1 it, 113 <br />ROF U ANTA NIN <br />O <br />MAIL STOP: M-36 <br />EXT.: 5665 <br />AGREEMENT NUMBER (if amendment): A / N ON -CALL APPRAISAL & R/W COORDINATOR AGREEMENTS <br />AMENDMENT NUMBER (if applicable): ❑ 1ST ❑ 2ND F1 3RD ❑ <br />NAME OF CONSULTANT / PARTY: <br />Bender Rosenthal li <br />Source Inc. <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 />Approval. <br />❑ 1) NOT approved by council. <br />❑ 2) Approved by council. <br />COUNCIL APPROVAL DATE: October 04, 2016 ITEM #: <br />TERM OF AGREEMENT- EFFECTIVE DATE: October 04, 2016 TERMINATION DATE: <br />SIGNATURES REQUIRED: ❑ VENDOR PJAGENCY <br />❑ CITY ATTORNEY ❑ OTHER <br />October 03, 2019 <br />(INSURANCE APPROVAL REQUIRED BY CAD PRIOR TO 'SUBMITTING TO COTC), <br />INSURANCE REQUIRED: © YES ❑ NO (Provide City Attorney Office approval) <br />® AUTO Z CGL (Commercial General Liability) <br />❑ PROFESSIONAL LIABILITY ® WORKERS COMPENSATION <br />COMMENTS: Please contact Mona lskandar for pickup X5013 or miskandar@santa-ana.org, <br />* Charter amendment effective December 21, 2006 for City Manager contract authority increase; NS-2717 <br />I:tAgreements\Fon -AGREEMENT PROCESSING FORM_canary.doc <br />Revised: 1/17/2012 <br />