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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />8/10/16 <br />Shawn Delahanty Department IT <br />BPW Date 8/23/16 Phone Extension 6205 <br />L Required Prior to Submittal to Board --� <br />Legal ® Attorney Name Michael Schmidt <br />Controller ® Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing <br />Check the Appropriate Item Type — Required for All Submissions <br />❑ <br />Agreement <br />❑ Contract ❑ Proposal ❑ Addendum <br />❑ <br />Professional Services <br />❑ Resolution <br />❑ <br />Bid Opening <br />❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ <br />Quote Opening <br />❑ Quote Award <br />❑ <br />Change Order No. <br />❑ C/O & PCA No. ❑ PCA <br />❑ <br />Ease/Encroach. <br />❑ Traffic Control <br />6a <br />Other: Renewal <br />Information <br />Company or Vendor Name CDWG <br />New Vendor ❑ Yes ® No ❑ If Yes, Approved by Purchasing <br />MBEM/BE Contractor ❑ MBE ❑ WBE <br />MBEM/BE Contractor Requested ❑ No ❑ Yes Name of Company <br />Renewal of Microsoft Licensing under 3 year Contract approved <br />Project Name 2015 <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of <br />15-36.04 <br />Annual Renewal of Microsoft Office Email Subscriptions CRM and <br />Visio Licensing <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verifv. Iran, etc.) <br />Increase <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Copy Original <br />® ❑ Shawn <br />For Chanqe Orders <br />U�0 <br />0/0 <br />Dispersal After <br />