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N- 2013 -157 <br />COTC PROCESSING FORM <br />Agreements / Amendments / Deeds 201, t,!vV .-7 41 9: 39 <br />ttI , <br />'X° ANA <br />(�N{ <br />CL L <br />TO: CLERK OF THE COUNCIL OFFICE <br />FROM: DEPT.: DEVELOPMENT ENGINEERING MAIL STOP: M -93 <br />PROJECT MANAGER: ANDERSON CHRYSOSTOMO EXT.: 5838 <br />AGREEMENT NUMBER (if amendment): A / N NA <br />AMENDMENT NUMBER (if applicable): ❑ 1ST ❑ 2ND ❑ 3RD ❑ <br />NAME OF CONSULTANT/ PARTY: HOUSING AUTHORITY OF THE CITY OF SANTA ANA <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: NA ITEM #: <br />TERM OF AGREEMENT- EFFECTIVEDATE: TERMINA TION DA TE: <br />SIGNATURES REQUIRED: ❑ VENDOR AGENCY <br />❑ CITY ATTORNEY [�/] OTHER <br />(INSURANCE APPROVAL REQUIRED BY CAD 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: SIGNATURE BY CITY MANAGER AND CITY CLERK ON CERTIFICATE OF <br />ACCEPTANCE FOR SEWER EASEMENT. <br />USE ONLY: ❑ PROCESS ❑ 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 />I:IAgreementfform- AGREEMENT PROCESSING FORM_canary.doc <br />Revised: 1117/2012 <br />