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PUBLIC WORKS ENGINEERING CONTRACT ROUTING <br /> DATE• August 13, 2009 Contract # 2008-00225 <br /> Amendment/Addendum # <br /> TO• FOR• Good Job #various <br /> ® Project Manager & Supervisor ®Initials ? Signature <br /> ® Division Manager ®Initials ? Signature <br /> ® Public Works Director ®Initials ? Signature <br /> ® City Manager ®Signature <br /> ? PW Administration ®Return to: Jeanne Oakes x5257 n, PWE-99 E. Broadway, Suite 400 <br /> Contractor: ODOT <br /> Contract Title: IGA-Local Agency Certification Program Agreement <br /> Manager: Jenifer Willer x5364 @ PWE-99 E. Broadway, Suite 400 <br /> Contract Type: IGA <br /> ? Operating ? Capital ? Expense ? Revenue <br /> Begin Date: upon signing Review Date: Term Date: <br /> Descri tion of contract/a reement: <br /> This non-discrimination agreement and policy statement are a requirement of the City's ODOT/FHWA <br /> certification. These documents have been developed by ODOT to meet the requirements of FHWA for <br /> compliance with Title VI of the Civil Rights Act of 1964. Form to be filed with original contract between <br /> COE and ODOT. <br /> Original Contract Amt: $ Requisition # <br /> Account Code: <br /> Existing Contract/Amendment Total $ RFQ/RFB/RFP # <br /> New Contract/Amendment Total: $ P.O. # <br /> Authorization Name: <br /> If Capital, do not fill out sectian below. <br /> Account Code: Amount: <br /> Account Code: Amount: <br /> Account Code: Amount: <br /> Total: <br /> Notes: <br /> <br /> Forward To: ? Purchasing ? City Attorney's office ? City Recorder's <br /> ® Tammy PWA ? Contract Manager ? File <br /> <br />