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a <br />COTC PROCESSING FORM <br />Agreements / Amendments / Deeds <br />TO: CLERK OF THE COUNCIL OFFICE <br />FROM: DEPT.: Personnel/Risk Management <br />PROJECT MANAGER: Briza Morales <br />1016 OCT It AM II.41 <br />VTT OF SANTA ANA <br />CL RK OF COUNCIL. <br />MAIL STOP: <br />EXT: <br />Clear Form <br />M. <br />5470 <br />AGREEMENT NUMBER (if amendment): A / N A-2014-241 <br />AMENDMENT NUMBER (if applicable): ® IST ❑ 2ND ❑ 3RD ❑ <br />NAME OF CONSULTANT/ PARTY: Ventiv <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: <br />TERM OF AGREEMENT- EFFECTIVE DATE: <br />ITEM #: <br />09-30-2016 <br />TERMINATION DATE: 09-30-2017 <br />SIGNATURES REQUIRED: F7 VENDOR ❑AGENCY <br />Z CITYATTORNEY ❑OTHER <br />(INSURANCE APPROVAL REQUIRED BY CAO PRIOR TO SUBMITTING TO COTC) <br />INSURANCE REQUIRED: 0 YES ❑ NO (Provide City Attorney Office approval) <br />❑ AUTO ❑ CGL (Commercial General Liability) <br />® PROFESSIONAL LIABILITY WORKERS COMPENSATION <br />RIC yjildil4illt&S <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:\Agreements\Form -AGREEMENT PROCESSING FORM_canary.doc <br />Revised: 1/17/2012 <br />