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CONTRACT/AGREEMENT TRANSMITTAL FOR _+ EQEllvE <br /> To be completed by initiating department: DEC-1 0 2010 <br /> Contractor/Consultant Name: _ 4/FE'73;,ry.E- 7-r,,.,v/S ,βœ“C. CITY CL :. r E <br /> Existing Contract? Yes No (If Yes, Enter) Contract Number: <br /> Subject/Summary: β€ž5" go R i7Rw-70f 4dR l4' -r- 1-o <br /> M 44' 1-2-4v/t.)5 ic/til , A-r- use)/ βœ“/-«0/ 444r, <br /> 44111 <br /> Initiating Department: ry4S Staff Member: i_ Telephone ext.: 5 <br /> Funding Source: 11X44,7" Budgeted: Yes No <br /> (If no,explain on attached sheet) <br /> Surety and/or Performance Bond(s) Yes No if required, attach bond(s)to the contract. <br /> /n.Mk (4.4'// .roβ€ž r6 CC <br /> Certificate(s) of Insurance attached: GI V Auto Excess W/C Prof. Other <br /> Pleasanton Business License No.: O5e,778 Expiration Date:' 1Airi/0 <br /> Consultant required to file statement of economic interest. Yes Vf No <br /> (To Be Determined By City Attorney) <br /> Executed agreement will be mailed to name and address on contract unless otherwise indicated below: <br /> Attorney with whom you have worked with on the contract: Jonathan/Julie/ Larissa/Renee (Circle One) <br /> Li Signature to be notarized or Document to be Recorded by City/ or Return to <br /> To be completed by City Clerk's Office: <br /> Date Routed./ - ' <br /> Ci To: CITY ATTORNEY'S OFFICE <br /> Forward To: CITY MANAGER 76 i(_ /7?Ap//o <br /> I 1 Sign and Initial on Revised Sections <br /> Return signed documents to the Office of the City Clerk <br /> All contracts/agreements must be initially sent to the City Clerk's Office. The City Clerk's Office will not route an <br /> agreement until it receives at least 1 agreement signed by the consultant/contractor and all supporting documents <br /> (e.g., insurance certificates, bonds and business license verification). If the agreement is for a CIP project or if <br /> another public entity would like an original, route at least 2 signed agreements. <br /> X:\forms\contract routing form <br />