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TO: <br />Ir.1011T, <br />COTC PROCESSING FORM <br />Agreements / Amendments / De"§ ocl 13 AM R <br />CITY OF <br />CLERK OF coutCIL <br />CLERK OF THE COUNCIL OFFICE <br />DEPT.: Design/PWA <br />MAIL STOP: M36 <br />PROJECT MANAGER: Kennv Nauven EXT.: 5632 <br />AGREEMENT NUMBER (if amendment): A / N <br />AMENDMENT NUMBER (if applicable): ❑ 1 ST ❑ 2ND 0 3RD <br />NAME OF CONSULTANT I PARTY: The Gas Company Temp Right of Entry Agreement <br />I $y' 9d <br />AMOUNT: ❑ * OVER $25,000 —(A) ❑ *UP TO $25,000 - (N) IN", ! � 'I" ex"'eds $y' <br />rill to a Fiscal yi"ar' zhmn you wifl need w 0"Aam C'ound <br />App;ova6' <br />1) NO, approved by womrd <br />❑ 21 AlpmovCT", by council' <br />COUNCIL APPROVAL DATE: <br />TERM OF AGREEMENT- EFFECTIVEDATE: <br />8/4/14 <br />ITEM #: <br />TERMINATION DATE, <br />SIGNATURES REQUIRED: 17-1 VENDOR Q AGENCY <br />❑ CITY ATTORNEY ❑ OTHER <br />9/21114 <br />(INSURANCE APPROVAL REQUIRED BY GAO PRIOR TO SUBMITTING SUBMITTING TO COTC) <br />INSURANCE REQUIRED: [] YES 0 NO (Provide City Attorney Office approval) <br />❑ AUTO ❑ CGL (Commercial General Liability) <br />❑ PROFESSIONAL LIABILITY ❑ WORKERS COMPENSATION <br />COMMENTS: Please call Marilyn Boothe for pickup of a copy, Thank you. X5013 <br />* Charter amendment effective December 21, 2006 for City Manager contract authority increase; NS-2717 <br />:IAgreementfform - AGREEMENT PROCESSING FORM—canary.doo <br />Revjsedt 111712012 <br />