Insurance Services Agreement - Gibson Insurance Agency - Advisory and Brokerage Property and Casualty Insurance

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 1/8/18 Name Jen Hockenhull Department A/F BPW Date 1/23/18 Phone Extension 9822 Required Prior to Submittal to Board Legal Attorney Name Clara McDaniels Controller review is required for all Contracts $5,000.00 or more Controller and greater than one year in length per the City Purchasing Policy Purchasing [Z - Check the Appropriate Item Type - Required for All Submissions Agreement El Contract 0 Proposal El Addendum Z Professional Services F-1 Amendment F-1 Bid Opening El Bid Award El Req. to Advertise E] Title Sheet F-1 Quote Opening F-1 Quote Award E] Chg, Order No. E] C/O & PCA No. F-1 PCA El Ease./Encroach. El Traffic Control F-1 Resolution El Other: [:] Claim Re aired Information Company or Vendor Name Gibson Insurance Agency, Inc. New Vendor Ell Yes ❑ If Yes, Approved by Purchasing E No M'BE/WBE Contractor ❑ MBE Completed E-Verify Form Attached ❑ WBE El Yes No Project Name Advisory & Brokerage Services Project Number n/a Funding Source Liabi.lity Insurance Reserve Account No. 226-0417-672.31-0�6 Amount $59,500 Terms of Contract Quarterly Installments Purpose/Description 2018 advisory and brokerage services relating to property & casualty insurance needs. For Change Orders Only Amount of ❑ increase $ ❑ Decrease $ Previous Amount $ Current Percent of Change: % New Amount Total Percent of Change Time Extension: Copy Original E F-1 F] El 11 F] Jennifer Hockenhull