Submitting Department/Staff Contact

CITY OF SARATOGA TRANSMITTAL MEMORANDUM FOR CONTRACT EXECUTION

Submitting Department/Staff Contact:

Please sign each copy of the attached, where indicated and return to the City Clerk. When the contract is fully execut ed the City Clerk will return either a duplicate original or copy to the submitting department and will send a certified copy to contractor/consultant.

Route To:

Department Director

Scope of Work Term Terms of Payment Use of City Facilities Not Approved Bond Requirements: City Attorney Contract under $25,000 – No Bonds Required Approved as to Form Contract over $25,000 – Bonds Required: Approved with Changes Surety licensed for CA – confirmed from: Not Approved http://interactive.web.insurance.ca.gov/companyprofile/co City Attorney Initials/Date______mpanyprofile (enter company name, check if “surety” is listed under “lines of business”, print page, and attach to contract Administrative Services Director Insurance Requirements:

Funding Available Commercial/General Liability No Funding Available Auto Liability Budget Resolution Required Professional/Errors and Omissions Notes: ______Worker’s Compensation Director’s Initials/DateCity ______Clerk Additional Insured Endorsement Public Works Contracts – all insurance specified on page 14

City Manager

Approved Denied City Manger’s Initial’s /Date: ______

1. Contractor Name:

2. Business License: Yes No License Number: Date of Expiration 3. Brief description of services to be provided:

Last Revised Feb. 6, 2013 1 4. Contract amount & budget account number:

5. City Services and Facilities to be provided (Summary of Exhibit C):

6. Designated Contract Administrator (Name and Title):

7. Is this a standard City contract? Yes No If no, explain: ______

8. Contract Date: Expiration Date:

9. Insurance Certificate attached: Yes No If no, explain: ______

10. Procurement:

Service Contract under $25,000 – (City Manager’s authority)

Service Contract $25,000 or over – (City Council approval required) Date of Council approval: ______or Res. No.: ______Attach Minute Order Attach Signed Resolution

Public Works Contracts below $175,000 (City Manager’s authority required)

Public Works Contracts above $175,000 (City Council’s approval required) Date of Council approval: ______or Res. No.: ______Attach Minute Order Attach Signed Resolution

11. Account number(s):

Approval Process Complete – Copy of Transmittal Memo forwarded to AS Department.

______Crystal Bothelio Date City Clerk

Last Revised Feb. 6, 2013 2