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- <br /> PUBLIC WORKS PARKS/OPEN SPACE CONTRACT ROUTING <br /> DATE: 2/10/2005 Contract # 2005-05321 <br /> Amendment/Addendum # <br /> Good Job # 3 DD <br /> TO: FOR: <br /> ® Project Manager ®Initials ?Signature <br /> ®Division Manager ?Initials ®Signature <br /> ? Public Works Director ?Initials ?Signature <br /> ? City Manager ?Signature <br /> I~, ®PW Admin./Budget(Peggy Ham ' U~ ®Return to: Webb Sussman (x. 4966) @ PWM/POS <br /> (ContractAdministrator) <br /> Contractor: Advanced Marketing Research, Inc. <br /> Contract Title: Santa Clara Community Park Survey <br /> Manager: R. Hostick X t,{ 9 ~ S <br /> Type: ®PS ? AIA ? IGA ? Lease ? <br /> Begin Date: 2/1/2005 Review Date: 12/1/2005 Term Date: 2/1/2006 <br /> Descri tion of contract/agreement: <br /> Contractor will carry out a survey using telephone interviews. Contractor will design the questionaire <br /> instrument and review pre and post-test drafts with City personnel prior to carrying out the final survey. <br /> Contract will start 2/1/2005 and will complete work prior to 6/1/2005 and cost will not exceed $12,500.00. <br /> Budget Information: Requisition # ZUUS OS O 3 3131.~V.~ ~ <br /> Contract Total: $12,500.00 P,p, # '~~U j '3 <br /> Authorization Name: Peggy Hamlin <br /> <br /> ~ <br /> ('l ~ , <br /> Account Code: 321-9335-~i,13'~9-915142 Amount: $12,500.00 <br /> Account Code: Amount: <br /> _ <br /> Account Code: Amount: <br /> Account Code: Amount: <br /> Total: $12,500.00 <br /> I! Notes: ~ ~ll-~ C~ 3~ 3U~~ ~ ~ <br /> PLEASE ROUTE ALL CAPITAL PURCHASE ORDERS AND CHANGE ORDER COPIES TO <br /> DEBBIE CLARK @ PWA, x 5728 <br /> Forward To: ? Purchasing ? City Attorney's office ®City Recorder's office <br /> P:\Finance&Admin\CONTRACTS\FORMS\RoutingFonn.doc <br /> <br />