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APPENDIX H CITY OF EUGENE STANDARD CONTRACT COVER SHEET F9.- d'O Date: .c /o0IA7 Contract Number: r' D Title or Purpose of Contract: /71 Federal Funds: ❑Yes ❑No Amount: $ � /� ,,(� 1 Account Code: ! ,�j' Contractor's Name: ` - u .14 ` 1 T� C 1i, .4.J'..1. Phone: Address: Administrator: n . e L ,9! y ,06 Contra Phone: Responsible Department: � Other Departments Involved: 14, " oex- ��,,�� C3 Finance Officer &r (Check): LIC(;ity Manager Manner of Award: ❑ Formal Bid ❑ Formal Quotation ❑ Professional Service In File Required In File Required General Requirements If Contract is for Community Development Project L --_ L -_-1 1. Eugene's standard contract 1----1 L____1 1. Certification of contractor's provisions eligibility i____-_11-- 2. Hold harmless clause and L__-__J 1__--1 2. Notice of preconstruction conference proof of insurance coverage refer to Appendix "A" CEPCPM 1_____1_____J t i 3. Notice of Section 3 contract award L_-J I-1 1 3. Independent contractor's declaration t__-J 1---J 4. Preconstruction conference summary cf "A" CEPCPM t._-J 1-1 5. Minority standards form L I L.-J 4. Performance bond L---I I___-1 6. Neighborhood group recommendation ;___ __1 1.__J 5. Bid tabulation and record of (over $10,000 only bid invitation or L _ - J L._J 7. Certification of non - segregated facilities ___ 1J quotations or �� L_J 8. Certification of equal employment L__J l proposals and requests for proposals opportunity 1-___11---1 6. Affidavit of contractor's L -J __ t 1 9. Contractor's notification of compliance sub - contract awarded L_ -J 1_,__J 7. Agency approval for final payment L_J L____-.1 10. Contracting activity report on federal or state projects 8. Review and approval - City Atty. I1 L__- --1 11. Preconstruction conference summary i___-1 L______1 _-- checklist L -J L_J 9. Council approval • Date: If Contract is for HCC Rehabilitation Loan L_J L----J 10. Resolution No.: i I t---1 1. Promissory note L_J L__1 11. Other L__.__1 L.---1 2. Mortgage 1_.J t__--J 3. Mortgage title insurance. policy If Contract is for Right -of -Way Property Appraisal i L __J 4. Borrower's loan application L_-_I t I 1. Appraisal specifications, drawings and maps L.. J L. --..1 5. Credit Report L____ J 1--J 2. Agreement UD or appraisal isal form 1 .J 1----1 6. Advice to borrower I J 1---I 7. Order to proceed 1..__-_J 1.--J 3. Appraisal review agreement g, Loan disbursement record (with HUD or DOT funds) 1___--1 1 _-J 1 J t__.1 9. Contract completion affidavit If Contract is for Professional Services t 1 L_J 1. List of consultants contacted If Contract is for Sale of Land and Private Development 2. Selection committee L______1 L._. -J 1. Development documents and offering 1.--1 L.-_J recommendations schedule 1_____1 L_J 2. Land sale notice and development If Contract is for Capital Improvement proposal solicitation ..• t ,_J_i .__._ invoice- and-affidavit of publication .._ �.. 3. ,,- -. i i °L -J 1. Contractos'i notice of award -- of sale notice and proposal solicitation L _J 1______J 2. Project work schedule L. 1 _ 1 4. Public notice of intention to execute ICJ L____ -J 3. Inspection reports contract 4. Wage certifications L___ -J t-.- -1 5. Invoice and affidavit of publication I i l__J of intent L---1 5. Final release certificate L`J L __J 6. Authorized Renewal Agency signatures L J L.-___J 6. Contract estimate report L�J 7. Evidence of recording contract with County (CA 18 & 19- progress payments) L-1 Department of Records and Elections t_ L_--J 7. Notice of proposed call for bids t _____J 8. Evidence . Evidenc of equity capital and mortgage and assessments (public works t--- -J Evidence of commitment capital improvement assessed) 1.____-.J L-_J 9. Deed copy L-_J 1_. --_1 10. Title Insurance copy 1_J L_J 11. Record of purchase price L. L - 12. Documentation v of EEO conference with L.-_J 1_-J 13. Certificate of completion , I %. THIS CONTRACT TERMINATES ON I J . A ' . IT SHOULD BE REVIEWED BY ON-- ---- -• FA • 0001 (1/80)