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COTC PROCESSING FORM... - <br />l; Agreements / Amendments / Deeds 2916 OCT 31 AN 11: 112 <br />CITY OF SANTA APIA <br />CLERK OF COUNCIL <br />TO: CLERK OF THE COUNCIL OFFICE <br />FROM: DEPT.: Design Engineering <br />MAIL STOP: <br />PROJECT MANAGER: Mindv LV EXT.: <br />M-36 <br />5665 <br />AGREEMENT NUMBER (if amendment): A / N <br />AMENDMENT NUMBER (if applicable): <br />NAME OF CONSULTANT / PARTY: Marshal <br />❑ 1ST ❑ 2ND 3RD ❑ <br />Kelley, LLC P&S Agreement/NOTARY <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: 10/18/16 ITEM #: <br />TERM OF AGREEMENT- EFFECTIVE DATE: <br />10/18/16 <br />TERMINATION DATE: <br />n/a <br />SIGNATURES REQUIRED:VENDOR ® AGENCY <br />R CITYATTORNEY ❑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: Please contact Mona Iskandar for pickup X5013 or miskandar@santa-ana.org <br />:RK OFFICE USE ONLY: ❑ PROCESS ❑ DO NOT PROCESS <br />❑ Needs Council Approval <br />❑ Missing Signatures <br />❑ Other <br />ADDITIONAL <br />* Charter amendment effective December 21, 2006 for City Manager contract authority increase; NS -2717 <br />hAgreements\Form -AGREEMENT PROCESSING FORM_canary,doc <br />Revised: 1/17/2012 <br />