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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 1131 /18 <br />Name Dan O'Connor Department Innovation & Tech <br />BPW Date 2/13118 Phone Extension <br />Legal Attorney Name McDaniels & Dougherty <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 <br />U <br />Agreement <br />LJ Contract <br />JJ Proposal U Addendum <br />❑ Professional Services <br />❑ Amendment <br />❑ <br />Bid Opening <br />❑ <br />Bid Award <br />❑ Req. to Advertise ❑ Title Sheet <br />❑ <br />Quote Opening <br />❑ <br />Quote Award <br />❑ <br />Chg Order No. <br />❑ <br />CIO & PCA No. <br />❑ PCA <br />❑ Ease./Encroach. <br />❑ Traffic Control <br />❑ Resolution <br />M <br />Other: Hardware Lease <br />n <br />Claim <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE .Contractor <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 />El <br />AT&T Mobility <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />® No <br />❑ MBE Completed E-Verify Form Attached ❑Yes <br />❑ WBE ❑ No <br />Mobile Tablet Leasing <br />IT Lease <br />279-0672-415-37-11 (principal) and 37-12 interest <br />$805 er month for 36 months $28,980 total <br />Monthly payments for 36 months <br />53 iPads with accessories for Sewers, VPA, Engineering Safety <br />& Risk, Vac Trucks, and IT; 4 Surfaces for pilot departments <br />Increase <br />Decrease <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />Time Extension: <br />Dispersal <br />Copy Original <br />® ❑ Dan O'Conner <br />® ❑ Jeff Weaver <br />® ❑ Shawn Delahanty <br />fter Reeroval <br />