Laserfiche WebLink
Date <br />Name <br />3/1/17 <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Department IT <br />BPW Date 3/14/17 Phone Extension 6209 <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 />Purchasing <br />Sue Gerlach <br />U Agreement Ll Contract ❑ Proposal ❑ Addendum <br />❑ Professional Services ❑ Resolution <br />❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening ❑ Quote Award <br />❑ Change Order No. ❑ C/O & PCA No. ❑ PCA <br />❑ Ease/Encroach. ❑ Traffic Control <br />N Other: Lease Addition <br />Company or Vendor Name <br />Hewlett-F <br />New Vendor <br />❑ Yes F <br />MBE/WBE Contractor <br />❑ MBE [ <br />MBE/WBE Contractor Requested ❑ No <br />Project Name <br />2017 Q <br />Project Number <br />N/A <br />Funding Source <br />Various <br />Account No. <br />Various <br />Amount <br />$8935.0 <br />Terms of Contract <br />$187.54 <br />Purpose/Description <br />New Co <br />Amount of H Increase <br />❑ Decrease <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Copy <br />Original <br />® <br />❑ Sue Gerlach <br />❑ <br />❑ <br />❑ <br />❑ <br />No LJ If Yes, Approved by Purchasing <br />WBE <br />Yes Name of Company <br />Lease Schedule <br />For 48 months <br />Dispersal After Approval <br />