Fillable ICC Addendum Instructions Sample (College of Alameda)

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ICC Addendum Instructions Sample (College of Alameda)

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Contractor/Consultant Information:
Name of Contractor:
Business License No.:
Tax ID Number:
Vendor Number:
Contract Information: Please attach a cover memo attention to the Chancellor
ICC # (Please attach a copy of the original ICC and previous addendums)
Contract Start Date: End:
New Contract End Date:
(Extension Request Only)
Original/Previous Contract Amount:
Request to Increase/Decrease the Contract By:
Total Contract Amount:
Board Approval Date(s): (if applicable)
Accounting Codes: (additional lines are provided for split funding only)
LOC FUND
COST
CTR
OBJECT PR
ACTIVITY
& SUFF
SPPJ LN
PREVIOUS
AMOUNT
ADDENDUM
+ / -
TOTAL
GRAND TOTAL
Funds Verified by Business Manager
Approval Routing:
College President
Vice Chancellor, Financial Services
Chancellor
Updated May 16, 2013
Date:
Date:
Date:
Date:
PERALTA COMMUNITY COLLEGE DISTRICT
INDEPENDENT CONTRACTOR & ORIGINAL CONTRACT
ADDENDUM FORM #
1
18961
07/01/2013
12/31/2013
06/30/2014
$ 135,000.00
$ 5,000.00
$ 140,000.00
01/21/2014
1
01
141
5104
1
672000
0000
00
$ 135,000.00
$ 5,000.00
$ 140,000.00
$ 0.00
$ 0.00
$ 0.00
$ 140,000.00
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ICC Addendum Instructions Sample (College of Alameda)

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Completed 3 September 2020

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