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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW RE QUEST FORM <br />Date 02/20/2018 <br />Name Patrick Sherman <br />Department VPA: Facilities & <br />Grounds <br />BPW Date 02/27/2018 Phone Extension 5601 <br />Required Prior to Submittal to Board' <br />Legal Attorney Name: <br />Clara McDani'els <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 <br />M Michael Schmidt <br />L] Agreement <br />L] Contract Proposal Award El Addendum <br />F-1 Professional Services <br />❑ Resolution <br />F] Bid Opening <br />❑ Bid Award El Req. to Advertise ❑ Title Sheet <br />Quote Opening <br />❑ Quote Award <br />Change Order No. <br />❑ C/O & PCA No. El PCA <br />Ease/Encroach. <br />F] Traffic Control <br />F-1 <br />Other: <br />Company or Vendor Name D.A. Dodd <br />New Vendor, 0 Yes M No E] If Yes, Approved by Purchasing <br />MBE/WBE Contractor R MBE F-1 WBE <br />MBENVB,E Contractor Requested E] No Yes Name ofCompany <br />_ <br />Project Name Venues Parks & Arts Plumbin Service Contract <br />Project Number 1041-2017 <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />FWAT, TIOW in ffol <br />Previous Amount <br />K61 -RMT <br />2011101452 36.01 <br />Dependent on services rendered <br />TBD after negotiation with firm selected <br />Provide a plumbing services contract for Venues Parks & Art: <br />H Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verifv, Iran, etc. <br />D increase <br />El Decrease <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Copy <br />Original <br />1:1 <br />1:1 <br />F1 <br />1:1 <br />El <br />1-1 <br />Dispersal After Approval <br />