Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 12/11/2017 <br />Name Amy Shirk, Senior Budget Analyst Department Admin & Finance <br />BPW Date 12/21/2017 Phone Extension 9133 <br />Required Prior to Submittal to Board <br />Legal F-1 Attorney Name <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 1-1 <br />LJ Agreement L' LJ �ontract Proposal L] Addendum <br />F-1 Professional Services Resolution Uq - M \-1 <br />F� Bid Opening Bid E] Req. to Advertise El Title Sheet <br />F-1 Quote Opening F-1 Quote Award <br />[J Change Order No. E] C/O & PCA No. PCA <br />El Ease/Encroach. F-1 Traffic Control <br />M Other: Disr)osals <br />Company or Vendor Name <br />New Vendor F1 Yes E] No I <br />MBEAA1BE Contractor ] MBE OWBE <br />MBENVBE Contractor Requested n No 0 Yes <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 />If Yes, Approved by Purchasing <br />Name of Company <br />Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Required For Change Orders Only <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 />F-1 <br />F-1 <br />F-1 <br />F-1 <br />El <br />El <br />