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3c w A-1 b <br />J' t Wes,.-JCIG�-�'• <br />- COTC PROCESSING FORM <br />Agreements / Amendments / Deeds ,,, 0Cj 31 AM 11: 43 <br />'CITY OF SANTA AAA <br />TO: CLERK OF THE COUNCIL OFFICE CLERK OF COUNCIL <br />FROM: DEPT.: Design Engineering MAIL STOP: <br />PROJECT MANAGER: Mindy Lv NEXT.: m <br />AGREEMENT NUMBER (if amendment): A / N <br />AMENDMENT NUMBER (if applicable): ❑ 1ST ❑ 2ND ❑ 3RD ❑ <br />NAME OF CONSULTANT / PARTY: Robert Daniel Walker - P&S Agreement ($20,700.00) / NOTARY <br />M-36 <br />5665 <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 TERMINATION DATE: <br />SIGNATURES REQUIRED: ❑ VENDOR © AGENCY <br />❑ CITYATTORNEY ❑OTHER <br />n/a <br />(INSURANCE APPROVAL'; REQUIRED BY CAO PRIOR TO 'SUBMITTING TO,'COTC), <br />INSURANCE REQUIRED: ❑ YES m 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 />❑ DO NOT PROCESS <br />❑ Needs Council Approval <br />❑ Missing Signatures <br />❑ Other <br />* Charter amendment effective December 21, 2006 for City Manager contract authority increase; NS-2717 <br />L1Agreements\Form -AGREEMENT PROCESSING FORM_canary,doc <br />Revised: 1/17/2012 <br />