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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />1/16/18 <br />Jen Hockenhull <br />Department A/F <br />BPW Date 1/23/18 Phone Extension 9822 <br />Legal Attorney Name Clara McDaniels <br />Controller review is required for all Contracts $5,000,00 or more <br />Controller and greater than; one year in length per the City Purchasing <br />Policy <br />Purchasing Z <br />Agreement <br />L Contract <br />H <br />Proposal L] Addendum <br />Z <br />Professional Services <br />F-1 Amendment <br />❑ <br />Bid Opening <br />❑ Bid Award <br />❑ Req. to Advertise ❑ Title Sheet <br />❑ <br />Quote Opening <br />❑ <br />Quote Award <br />❑ Chg Order No. <br />El <br />C/O & PCA No, <br />E] PCA <br />❑ Ease./Encroach. <br />F] <br />Traffic Control <br />n Resolution <br />Other: <br />F1 <br />Claim <br />Company or Vendor Name <br />New Vendor <br />100-FOANT0.110STM ".4 Ma <br />Project Name <br />Project Number <br />Howard E Nyhart Co Inc. <br />If Yes, Approved by Purchasing <br />M No, <br />F-1 RARF <br />El WBE Completed E-Verify Form Attached <br />GASB 45 Actuarial Valuation Report <br />n/a <br />Yes <br />FE-M <br />Funding Source <br />General Fund <br />Account No. <br />101-0401-415,31-06 <br />Amount <br />$7,500 for 2017 report; $8,600 for 2018 report (additional work <br />required for 2018 to be in compliance with new GASB) <br />Terms of Contract <br />Due upon receipt of report <br />Purpose/Description <br />Actuarial valuation required for annual audit and CAFR. Refer to <br />contract for further discussion on work to be performed. <br />ChangeFor Orders On!ly <br />Amount of F-1 <br />increase $ <br />[:] <br />Decrease $ <br />Previous Amount <br />$ <br />Current Percent of Change. % <br />New Amount <br />Total Percent of Change: % <br />Time Extension: <br />Dispersal After Approval <br />Copy Original <br />M F-1 <br />Jennifer Hockenhull <br />F] 1-1 <br />El F <br />