Laserfiche WebLink
COTC PROCESSING FORM <br />Agreements / Amendments / Deeds <br />TO: CLERK OF THE COUNCIL OFFICE <br />FROM: DEPT.: DEVELOPMENT ENGINEERING <br />N- 2013 -14,0 <br />2D NOR' - Ad 4:44 <br />.A <br />MAIL STOP: M -93 <br />PROJECT MANAGER: ANDERSON CHRYSOSTOMO EXT.: 5838 <br />AGREEMENT NUMBER (if amendment): A / N NA <br />AMENDMENT NUMBER (if applicable): ❑ 1 ST ❑ 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- EFFECTIVE DATE: TERMINATION DATE: <br />SIGNATURES REQUIRED: ❑ VENDOR ®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 ❑ CGL (Commercial General Liability) <br />❑ PROFESSIONAL LIABILITY ❑ WORKERS COMPENSATION <br />COMMENTS: SIGNATURE BY CITY MANAGER AND CITY CLERK ON CERTIFICATE OF <br />ACCEPTANCE FOR OFFER OF DEDICATION. <br />CLERK OFFICE 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 />1:1Agreement0orm -AGREEMENT PROCESSING FORM_canary.doc <br />Revised: 1117 /2012 <br />