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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 1/13/17 <br />Name John Murphy , \�� Department Adm/Finance <br />BPW Date 1/24/16') Phone Extension 7678 <br />I Required Prior to Submittal to Board <br />Legal <br />Controller <br />Attorney Name Michael Schmidt <br />® Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing ® <br />George King <br />Check the Appropriate Item Type — Required for All Submissions <br />❑ <br />Agreement <br />❑ Contract ❑ Proposal ❑ Addendum <br />❑ <br />Professional Services <br />® Resolution <br />❑ <br />Bid Opening <br />❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ <br />Quote Opening <br />❑ Quote Award <br />❑ <br />Change Order No. <br />❑ C/O & PCA No. ❑ PCA <br />❑ <br />Ease/Encroach. <br />❑ Traffic Control <br />❑ <br />Other: <br />pany or Vendor Name None <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of <br />Information <br />Yes ❑ No ❑ If Yes, Approved by Purchasing <br />MBE I-1 WBE <br />Resolution Changing the Effective Date of Annual Payroll Increases <br />None <br />Various Departmental Budgets <br />Various <br />$ Amount will vary from year-to-year <br />A resolution changing the effective date for annual pay increases for <br />bargaining employees, nonbargaining employees and elected officials to <br />the first pay date of the year rather than January 1 st (which likely will <br />occur in the midle of a pay period). The check for the first pay date will <br />cover the pay period that overlaps year-end. <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verifv. Iran, etc <br />Increase <br />Decrease <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Dispersal After Approval <br />Copy <br />Original <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />