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Routing order: <br /> <br />Contractor: ______________________________________________ <br />New Amendment Contract # __________ Sole Source: Yes No <br />(If yes, explain below) <br />Approved by Council: Yes No Meeting Date: ____________ (If no, explain below) <br />Subject/Summary: ______________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />Initiating Department: _____________ Staff Member: ________________ ext.: ___________ <br />Funding Source: ___________________________ Budgeted: Yes No (If no, explain below) <br />Surety/Performance Bond(s) Yes No (If required, attach to the contract) <br />Certificates of Insurance: GI Auto Excess W/C Prof. Other <br /> (Attach to the contract) <br />Business License No.: __________________ Expiration Date: ________ (do not attach) <br />Consultant requires filing a Statement of Economic Interest: Yes No (If no, explain below) <br />Executed agreement will be mailed to name & address on contract unless otherwise indicated: <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />Attorney consulted: Daniel Julie <br />Document to be recorded by: City Other <br />Larissa Wes <br />______________________________________ <br />Explanation(s): <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />______________________________________________________________________________ <br />CONTRACT/AGREEMENT TRANSMITTAL FORM <br />Embarcadero Media Foundation <br />4 2024227 4 <br />4 <br />PO Change Order to add additonal funds for the weekly Advertisement in Pleasanton Weekly. <br />City Clerk Jocelyn Kwong <br />00112100-435133 4 <br />Weekly Advertisement in Pleasanton Weekly. <br />DocuSign Envelope ID: 23291C6F-5A5B-4546-8691-B888202BA522