Laserfiche WebLink
Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />12-15-16 <br />Kim Thompson Department <br />BPW Date 12-22-16 Phone Extension 5969 <br />Required Prior to Submittal to Board <br />Legal ® Attorney Name Michael Schmidt <br />Controller ® Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Utilities <br />Purchasing <br />Check the Appropriate Item Type — Required for All Submissions <br />® <br />Agreement <br />❑ Contract ❑ Proposal ❑ Addendum <br />❑ <br />Professional Services <br />❑ Resolution <br />❑ <br />Bid Opening <br />❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ <br />Quote Opening <br />❑ Quote Award <br />❑ <br />Change Order No. <br />❑ C/O & PCA No. ❑ PCA <br />❑ <br />Ease/Encroach. <br />❑ Traffic Control <br />❑ <br />Other: <br />Required Information <br />Company or Vendor Name <br />Badger <br />Meter <br />New Vendor <br />❑ Yes Z No ❑ If Yes, Approved by Purchasing <br />MBE/WBE Contractor <br />❑ MBE ❑ WBE <br />MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company <br />Project Name <br />Beacon AMA Managed Solution for water meters <br />Project Number <br />N/A <br />Funding Source <br />Water Works O&M <br />Account No. <br />620-0640-605-31-06 <br />Amount <br />$ 33,226 <br />Terms of Contract <br />1 yr <br />Purpose/Description <br />Software to manage meter reading data and to transmit it for billing <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Required For Change Orders Only <br />Amount of ❑ Increase $ <br />❑ Decrease $ <br />Previous Amount <br />$ <br />Current Percent of Change: <br />% <br />New Amount <br />Total Percent of Change: <br />% <br />Dispersal After Approval <br />Copy Original <br />N ❑ Kim Thompson <br />❑ ❑ <br />❑ 11 <br />