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COTC PROCESSING FORM Clear Form <br />Agreements / Amendments / Deeds 7917 tlot, t t• 1114 n n c <br />TO: CLERK OF THE COUNCIL OFFICE <br />FROM: DEPT.: Parks, Recreation and Community Services Agency M-23 <br />MAIL STOP: <br />PROJECT MANAGER: Silvia Cuevas EXT.. 5254 <br />The following information must be provided <br />in requesting processing of agreements /amendments / deeds for the City: <br />AGREEMENT NUMBER (if amendment): A / N A-2015-188;W ( , <br />AMENDMENT NUMBER (if applicable): ❑ 1 ST 0 2ND 3RD © 4th <br />NAME OF CONSULTANT / PARTY: Fiesta de Carnival <br />AMOUNT: <br />© OVER $25,000 —(A) ❑ *UP TO $25,000 - (N) Note: It 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 />m 2) Approved by council. <br />COUNCIL APPROVAL DATE: 2/3/15 ITEM #: 20A <br />TERM OF AGREEMENT- EFFECTIVE DATE: 2/3117 <br />TERMINATION DATE: 2/2/18 <br />SIGNATURES REQUIRED: VENDOR Q AGENCY <br />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 0 CGL (Commercial General Liability) <br />NIB PROFESSIONAL LIABILITY m WORKERS COMPENSATION <br />COMMENTS: A-2015-019, A-2015-188, A-2015-18-02, A-2015-188-03, A-2015-188-04 <br />FOR CLERK OFFICE USE ONLY: ❑ PROCESS ❑ DO NOT PROCESS <br />❑ Needs Council Approval <br />❑ Missing Signatures <br />ADDITIONAL REMARKS: ❑ Other <br />r= 0111C1 UFO i F IL euective uecemoer 21, 2006 for City Manager contract authority increase; NS-2717 <br />hAgreemenWForm -AGREEMENT PROCESSING FORM_canary.doc <br />Revised: 1117/2012 <br />