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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date Feb 1, 2017 <br />Name Matthew L. Chlebowski Department Central Services <br />BPW Date Feb 14, 2017 Phone Extension 574-235-9316 <br />sRe wired Prior taSubmittal to Board <br />Legal ® Attorney Name Michael Schmidt <br />Controller El greater <br />review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing <br />Professional Services <br />Bid Opening <br />Quote Opening <br />Change Order No. <br />Ease/Encroach. <br />® George King <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />MBE/WBE Contractor <br />Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of <br />❑ Contract IJ Proposal LJ Addendum <br />❑ Resolution <br />® Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Award <br />❑ C/O & PCA No. ❑ PCA <br />❑ Traffic Control <br />Required Information <br />Pyramid E ui ment Inc. <br />Yes No ❑ If Yes Approved by Purchasing <br />I -I MBE I I WBE <br />No U Yes Name of Com <br />Spec (A)5000 more or less and 500 more or less <br />Universal/Nestable Refuse Carts <br />2017 Solid Waste Capital Lease Principal 611-0610-415- <br />3711/Interest 611-0610-415-3712(subject to lease funding) <br />$ 243,625.00 <br />Bid Opening Date: <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion. Non -Discrimination, Non -Debarment, E-Verify, Iran,_ etc <br />Increase <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Copy Original <br />® ❑ Matt <br />® ❑ Mike <br />❑ ❑ <br />Dispersal After Approva <br />Sheila <br />& Carol <br />Wisniewski <br />id Waste <br />