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CONTRACT ROUTING COVERSHEET -- CLERK'S OFFICE <br />Date: 3/18/25 <br />Person Routing: Anne <br />Department: Public Works <br />Weech <br />Fill Out Completely! Detailed instructions are available here <br />(* = Required for all contracts. Enter N/A if not applicable in remainder of fields) <br />Except for capital construction contracts, a complete contract pdf must be uploaded to Sharepoint <br />along with this coversheet <br />How will the City and the Contractor be signing the <br />contract?* (Select one from dropdown menu) <br />Exception: All signatures of all parties in ink (usually <br />All signatures with City AdobeSign System is now <br />only notarized contracts) <br />the City standard. Instructions here <br />List all contract page numbers that require <br />signatures/initials/notary of the Mayor or of the <br />10, 11 <br />Contractor/Agency/Vendor:* <br />Title (Describe work to be performed):* <br />Voluntary Compliance Agreement (VCA) <br />City Project Manager:* <br />Anne Weech <br />City Project Manager Email Address (This is where <br />aweech@everettwa.gov <br />AdobeSign will send an approval request and later <br />where a copy of the signed contract will be sent. <br />More than one City PM may be listed):* <br />Name of Contractor/Agency/Vendor. <br />8015 Broadway Everett LLC <br />If Contractor/Agency/Vendor is signing with City <br />N/A <br />AdobeSign, then enter name, title, and email <br />N/A <br />address of the specific individual who is signing the <br />N/A <br />contract for them.* If they are not signing with City <br />AdobeSign, enter "N/A". <br />AdobeSign Info Sheet Provided to <br />Contractor/Agency/Vendor? Yes ❑ No❑ N/A❑X <br />If the contract is a Trustlayer contract, then enter <br />N/A <br />the Contractor/Vendor/Agency insurance contact <br />information. Otherwise, enter "N/A." Insurance <br />contact information is only required for contracts to <br />N/A <br />N/A <br />Trustlayer Info Sheet Provided to <br />Contractor/Agency/Vendor? Yes ElNo❑ N/A❑X <br />be verified by TrustLayer, which only includes <br />construction contracts, long -form PSAs, leases, and <br />licenses. <br />Council Agenda Date: <br />N/A <br />Original Council Approval Date:* <br />N/A <br />Contract Expiration or End Date:* <br />April 15, 2025 <br />Amendment / Change Order #: <br />N/A <br />Contract No. (Federal, State, County). <br />N/A <br />Total Compensation Amount (enter $0.00 if N/A): <br />$0.00 <br />Contract Type:* (Select one from dropdown menu) <br />Other Agreements <br />Previous Action (If any) : <br />Notice of Violation and Order <br />L&I Verification. If the compensation amount is more than $10,000 and the <br />Have you verified <br />contract is a services agreement (such as a PSA), you must verify that the service <br />this? <br />provider is not listed at Employer Compliance with Employment Standards (wa.gov). <br />Yes ❑ No❑ N/A ❑X <br />The VCA provides additional time to the property <br />Project Description. <br />owner to bring the property into compliance. <br />v. 12.2.24 <br />