ADM-4 Contract or Equipment Lease Compliance Checklist

Contract or Equipment Lease Compliance Checklist
See ADM-4, Contracting for Service
Property*
Name of Property
Date Prepared*
MonthDayYear
Date
AGREEMENT DATE
Name of contractor or lessor*
Description of service or goods*
Previous provider*
N/A if new contract scope
Annual budgeted amount*
Input $0 if not budgeted
Reason for change*
Annual amount per agreement*
Original commencement date*
MonthDayYear
Date
Total amount over term*
Termination date*
MonthDayYear
Date
Prior annual amount*
Input $0 if new contract
CONTRACTS AND LEASES (provide explanation in “Remarks” for any item that is NOT checked)
Compared to previous agreement, cost is not more than 4% higher (also check block if this is the initial contract)Document is in name of ownership entity or as prescribed by management agreement.Agreement is assignable by owner.Agreement complies with management agreement and local supplement in all respects. Attach supplement. Attach owner approval if required.Provider has furnished Form W-9 also check if the form is already on fileAgreement can be canceled at will with 30 or fewer days’ notice.Agreement does not automatically renew.Payment terms are not more stringent than net 30.
SERVICE CONTRACTS ONLY
Check any of the following blocks that apply:
Competitive proposals are attached, along with a summary of the bids.Competitive proposals are not required by ADM-4.This is a request for waiver of bidding or re-bidding requirements of ADM-4.
MUST BE CHECKED:*
Contractor has furnished an insurance certificate with appropriate coverages naming the manager (Cousins Properties Incorporated or Cousins Properties Services LLC) and the owner as additional insureds.I have personally checked references and, if applicable, inspected previous work done by the contractor.Terms, conditions, and language conform verbatim to standard Cousins contract except as indicated in Remarks.
REMARKS: (must be provided is any of the above is NOT checked)
COORDINATION AND APPROVAL
Preparer: Indicate “N/A” on signature lines of individuals who are not required to review or approve this agreement. See Table 1 – Approving Authorities in ADM-4 for guidelines.
Each signer below affirms that there are no factors related to this contract that would disqualify him or her, as described in “Disqualification for Conflict of Interest” in ADM-4, Contracting for Service. If a signature of any person in the chain is omitted because of a conflict, write “Excused for conflict of interest” in the signature element.
Preparer Name:
REQUIRED
Preparer Signature:*
Clear
Property Manager Name:
REQUIRED
Property Manager Signature:
Clear
SPM/General Manager Name:
Signature Required up to $250,000
SPM/General Manager Signature:
Clear
PGM/Director of Operations Name:
Signature Required over $250,000
PGM/Director of Operations Signature:
Clear
Chief Engineer Name:
Engineering Contracts/Scope
Chief Engineer Signature:
Clear
Group Engineering Manager Name:
Engineering Related Scope
Group Engineering Manager Signature:
Clear
Should be Empty:

Contract or Equipment Lease Compliance Checklist

AGREEMENT DATE

SERVICE CONTRACTS ONLY

COORDINATION AND APPROVAL