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BOARD OF PU13LIC WORIK'S <br />AGENDA ITEM REVIEW RE, QUEST FORM <br />Date 12/28/17 <br />Name Matthew Coats Department Innovation & Technology <br />BPW Date 1/9/1 8 Phone Extension 5817 <br />Required Prior to Submittal to Board <br />Legal Attorney Name Ben Dougherty <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller El and greater than one year in length per the City Purchasing <br />Policy <br />Purchasing F] <br />H Agreement <br />H Contract <br />LJ Proposal L-1 Addendum <br />F-1 Professional Services <br />El Amendment <br />F-1 Bid Opening <br />El Bid Award <br />Z Req. to Advertise El Title Sheet <br />EJ Quote Opening <br />n Quote Award <br />n Chg Order No. <br />F] C/O & RGA No. <br />Ej PCA <br />F] Ease./Encroach. <br />EJ Traffic Control <br />❑ Resolution <br />M Other: <br />n Claim <br />Company or Vendor Name <br />TBD <br />[:] Yes ❑ If Yes, Approved by Purchasing <br />New Vendor <br />F-1 No <br />MBE/WBE Contractor <br />EIMBE Completed E-Verify Form Attached El Yes <br />FJWBE F] No <br />Enterprise Resource Planning (ERP) System and Implementation <br />Project Name <br />Services <br />Project Number <br />Funding Source <br />Other Professional Services <br />Account No. <br />404-067'2-415.31-06 <br />Amount <br />$ TBD <br />Terms of Contract <br />TBD after RFP Process <br />Purpose/Description <br />For Change Orders Only A ORD <br />Amount of F-1 increase $ <br />[:] Decrease- <br />$ <br />Previous Amount <br />$ JAN 1") 4, a11 A li <br />Current Percent of Change: <br />% <br />New Amount <br />$ <br />Total Percent of Change: <br />% <br />Time Extension. - <br />Copy <br />Original <br />F-1 <br />El <br />F] <br />F-1 <br />El <br />n <br />