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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 1/9/18 <br />Department Innovation & <br />Name Shawn Delahapty­... Technology_ <br />BPW Date 1/23/18 Phone Extension 6205 <br />Legal Attorney Name McDaniels <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller Z and greater than one year in length per the City Purchasing <br />Policy <br />Purchasing Z <br />LJ Agreement <br />H Contract <br />H Proposal L] Addendum <br />Z Professional Services <br />❑ Amendment <br />F-11 Bid Opening <br />❑ Bid Award <br />El Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening <br />El Quote Award <br />F-1 Chg Order No. <br />[:1 C/O & PGA No, <br />Fj PCA <br />R <br />Ease./Encroach. <br />F-1 Traffic Control <br />0 Resolution <br />F-1 <br />Other: <br />F-1 <br />Claim <br />Company or Vendor Name <br />New Vendor <br />I kyi 1 0.1 : FITA 0.1 z 11113•TIV R 7 on <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Ll Yes Ll If Yes, Approved by Purchasing <br />F] No <br />F-1 MBE F-1 WBE F-1 Yes <br />Completed E-Verify Form Attached El <br />Tier 1 and 2 HeloDesk <br />IT'Or)erati <br />279-0672-415-36-04 <br />$126,727.20 annually for 3 years plus a onetime fee of $2375 <br />($382,556.60 total, paid annually) <br />3 annual Davments for a 3 vear aareement <br />Tier 1 and 2 Tech HelpDesk <br />I For Change Orders Only <br />Amount of El increase $ <br />0 Decrease $ <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of'Change: % <br />Time Extension: <br />Dispersal After Approval <br />Copy Original <br />® n Shawn Delahanty <br />F-1 F1 <br />El El <br />