Laserfiche WebLink
COTC PROCESSING FORM <br />Agreements / AmendmentIPIA 100efl AN 9* 49 S� <br />CITYSANTA <br />0 ACCORUSH! <br />TO: CLERK OF THE COUNCIL OFFICE * /� <br />FROM: DEPT.: CA® MAIL STOP: <br />PROJECT MANAGER:�(V�(���(� �j EXT.: <br />AGREEMENT NUMBER (if amendment): A / N <br />AMENDMENT NUMBER (if applicable): <br />NAME OF CONSULTANT / PARTY: <br />AMOUNT: u OVER $25,000 — (A) <br />COUNCIL APPROVAL DATE: l <br />❑ IST ❑ 2ND E]3RD ❑ <br />❑ *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 T approved by council. <br />) Approved by council. <br />TERM OF AGREEMENT- EFFECTIVE DATE: <br />SIGNATURES REQUIRED:VENDOR <br />H CITY ATTORNEY <br />TERMINATION DATE: <br />❑ AGENCY <br />❑ 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 />COMM <br />I%7 <br />FOR CLERK OFFICE USE ONLY: ❑ PROCESS ❑ DO NOT PROCESS <br />❑ Needs Council Approval <br />❑ Missing Signatures <br />❑ Other <br />ADDITIONAL REMARKS: <br />W Charter amendment effective December 21, 2006 for City Manager contract authority increase; NS -2717 <br />I:IAgreementslForm-AGREEMENT PROCESSING FORM_canary.doc <br />Revised: 1/17/2012 <br />