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Date <br />Name <br />BOAIU) OF PUBLIC WORKS <br />AGENDA ITEM REVIEW RE, QUEST FORM <br />11/30/2017 <br />Department Innovation & Teqhnology_ <br />5897 <br />-BPW Date Phone Extension <br />- ------ . .... . <br />Rene Casiano <br />12/21/2017 <br />Legal Attorney Name Clara McDaniels <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 />N' Agreement <br />Ll Contract L] Proposal IU Addendum <br />F] Professional Services <br />n Resolution, <br />[:1 Bid Opening <br />El Bid Award E] Req. to Advertise El Title Sheet <br />F-1 Quote Opening <br />F] Quote Award <br />❑ Change Order No. <br />❑ C/O & PCA No. E] PCA <br />❑ Ease/Encroach. <br />Traffic Control <br />Other: <br />Company or Vendor Name Azteca Systems, LLC <br />New Vendor Z Yes E] No El If Yes, Approved by Purchasing <br />MBE/WBE Contractor F-1 MBE F WBE <br />MBE/WBE Contractor Requested F No F Yes Name of Company <br />Project Name - CityWorks Works Order Management Pilot Implementation <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of E] <br />El <br />Innovation Supplies <br />279-0673-415-21-05 <br />$27,0010 <br />CityWorks AMS licenses, 20 count <br />_Z Required Contractor's Certification Form Attached (Non - <br />Collusion. Non-Discdmination. 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 />Copy <br />Original <br />z <br />F] <br />1:1 <br />z <br />1:1 <br />1:11 <br />Ren6 Casiano, Dan O'Connor, Jeff Weaver, John Lankowicz <br />Josh Stroessner jstroessner@cityworks.com <br />