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BOA1W OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 03/06/20,18 <br />Name Patrick Sherman <br />Department VPA: Facilities & <br />Grounds <br />_BPW Date 03/13/2018 Phone Extension 5601 <br />Required Prior to,Submittal 'to , Board <br />Legal Attorney Name Clara McDaniels <br />Controller Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing E Michael Schmidt <br />Agreement Amendment <br />Professional Services <br />F-1 Bid Opening <br />Quote Opening <br />Change Order No. I <br />F-11 Ease/Encroach. <br />FI Other: <br />LJ Contract <br />F] Resolution <br />El Bid Award <br />El Quote Award <br />El C/0 & PCA No. <br />F-1 Traffic Control <br />A= <br />El Req. to Advertise <br />sm <br />FWATOrg <br />0 Title Sheet <br />Company or Vendor Name Cul'ligan Water <br />New Vendor F-1 Yes Z No ❑ If Yes, Approved by Purchasing <br />MBEANBE Contractor R MBE [:] WBE <br />MBE/VVBE Contractor Requested EJ No F-1 Yes Name of Company <br />Project Name Morris Performing Water Softener System <br />Project Number 1028-2017 <br />Funding Source <br />Accouint No. <br />Amount <br />K1 MPAC <br />416-0404-453-36.01 <br />$ 11,805,00, <br />Terms of Contract Lump Sum <br />Purpose/Description Increase of cost to fix dammed lar_qe brass valves. <br />Z Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment. E-Verifv, Iran. etc. <br />Amount of E] increase <br />[] Decrease <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Dispersal After Approval <br />Copy <br />Original <br />1:1 <br />F-1 <br />E] <br />F] <br />El <br />1:1 <br />