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CONTRACT COVERSHEET <br />NOTE: Shaded areas are for County Executive review. <br />DEPARTMENT <br />CONTRACT/ADDENDUM #: <br />Date Out <br />3 <br />'%,ti..t-..,:_,:. e. c �. .i_.'t,": 1-'t..::s r..% r,._, iti C.. `; d,�!'+✓s,A. L. `: f:'i`.t k-,�.,::'-` <br />1 t '° (� <br />1. This contract, grant or addendum: ❑ AWARDS ❑ ACCEPTSa <br />Contract Addendum <br />If Addendum, include <br />please <br />original contract number <br />j <br />Risk Management <br />2. This contract is discretionary 0 YES ❑ NO <br />0 POS <br />U <br />ADA Coordinator <br />❑ Co Lesse <br />❑ <br />w <br />DATE SIGNED 14 <br />3. Term of Contract arAddendum: From: To: JUNE 2013 <br />❑ Co Lessor <br />❑ Intergovernmental <br />❑ <br />❑ <br />4. Amount of Contractor Addendum $9000 <br />County Executive <br />❑ Purchase of Property <br />—j—) <br />5. Purpose: <br />CONTINUATION OF MONUMENT PERPETUATION AND <br />❑ Property sale <br />COORDINATE ACQUISITION IN COTTAGE GROVE <br />❑ other: <br />❑ <br />6. Vendor or Funding source: BOWDEN SURVEYING Ltd. <br />7. MUNIS Vendor Code: 22936 <br />8. Bid/RFP Number: 112049 <br />9. If grant: Funds Positions? ❑ YES 0 NO Will require on-going or matching funds? ❑ YES LINO <br />10. Are funds included in the budget? ❑ YES ❑ NO <br />11. Account No. & Amount, Org. & Obj. CP PLNDEV 58310 <br />Amount $ 9000 <br />Account No. & Amount, Org. & Obj. <br />Amount $ <br />Account No. & Amount, Org. & Obj. <br />Amount $ <br />12. Is a resolution needed: ❑ YES ❑ NO If "YES," please attach a copy of the Resolution. <br />If Resolution has already been approved by the County Board, Resolution No. & date of adoption <br />13. Does Domestic Partner equal benefYts requirement apply? ❑ YES ❑ NO <br />14. Director's Approval - *' <br />CONTRACT REVIEW/APPROVALS <br />Initials <br />Lyk Received <br />Ftnt Date In <br />13— <br />Date Out <br />3 <br />ontroller <br />5 /3 <br />Corporation Counsel <br />Risk Management <br />` i <br />ADA Coordinator <br />w <br />Purchasing Agent <br />— v 13 <br />l0 �. <br />County Executive <br />14-13 <br />—j—) <br />Footnotes: <br />0 <br />2 <br />Return To: Name/Title: Dept.: <br />Phone: Mail Address: <br />E-mail: <br />012-47 (2/13) <br />VENDOR <br />Vendor Name & Address <br />Contact Person <br />Phone No. <br />E-mail Address <br />