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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Mav 16, 2017 <br />Toni Laisure <br />LJ Agreement <br />❑ Professional Services <br />❑ Bid Opening <br />❑ Quote Opening <br />❑ Change Order No. <br />❑ Ease/Encroach. <br />(l Other: <br />Company or Vendor Name <br />New Vendor <br />MBENVBE Contractor <br />MBENVBE Contractor <br />Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Department Central Services <br />❑ No ❑ Yes Name of Company <br />Spec — Janitorial -Cleaning Supplies 2017 <br />Various <br />Amount $ <br />Terms of Contract July 1, 2017 — June 30, 2018, 1 year <br />Purpose/Description Bid Opening Date: June 13th, 2017 Award Janitorial -Cleaning <br />Supplies 2017, Central Stores bid. <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion. Non -Discrimination, Non -Debarment, E-Verify, Iran, etc. <br />Amount of ❑ increase $ <br />❑ Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount 1i <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy Original <br />❑ ® Toni Laisure, Central Services Division <br />❑ ® Sheila Enos, Central Services Division <br />® ❑ George King, Purchasing <br />