Non-Exclusive License Agreement - Triangle Homeowners Assoc - Use of City of SB Burns Triangle Right of Way

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date Name November 29„ 2018 Jitin Kain Department Public Works BPW Date December 11, 2018 Phone Extension 5835 im m maremmcn mmmmm Required Prior to Submittal to Board .m_ __._. ...._...__........... 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 Check the Agreement Professional Services Bid Opening Quote Opening ❑]' Chg Order No. Ease./Encroach. Other: Company or Vendor Name for All Si Proposal ❑ Req. to Advertise [� PCA El Resolution ❑ Claim Required Information Triangle Home Owners Association, Inc. iroprlate Item Tea_ E] Contract F1 Amendment El Bid Award El Quote Award [] C/O & PCA No. E] Traffic Control New Vendor LJ Yes No MBE/WBE Contractor ❑ MBE ❑ WBE Project Name Project Number Funding Source _............_..........w_. Account No. Amount If Yes, Approved by Purchasing Addendum ❑ Title Sheet Completed E-Verify Form Attached ❑ Yes ❑ No Terms of Contract No end date. However, can be terminated at any time by y vance written notice. _ .......................��ww �.m_..._......... Purpose/Description Non -Exclusive license to use the COSB Burns Triangle R-O-W area for HOA gatherings. For Ghaggp Orders Orrn.�._..... �.... Amount of Increase $ ...... _ _.. _ _......._..w. ❑ Decrease Previous Amount $ Current Percent of Change: New Amount �.........-......__..... Total Percent of Change:..........% Time Extension: —_ ................... Dispersal After Approval Copy Original El El El El 0 1-1