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BOAItD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />91 R TAII I <br />Lauren Tra <br />Department Utilities <br />BPW Date 3/27/20.18 —Phone Extension 5852 <br />Legal Attorney Name <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller F] and greater than one year in length per the City Purchasing <br />Policy <br />Purchasing F-1 <br />H Agreement <br />r_1 Professional Services <br />F-1 Bid Opening <br />[:] Quote Opening <br />F-1 Chg Order No. <br />❑ Ease./Encroach. <br />N Other: Industrial <br />Discharge Permit <br />Renewals for: McCormick <br />& Co. Inc, Monarch <br />Textile Rental on <br />Lincolinway West, <br />Monarch Texile, Rental on <br />Foundation Drive, and <br />Company or Vendor Name <br />New Vendor <br />Tki F0.1 F; RVITI A 190 Mao ME <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />H Contract <br />F-1 Amendment <br />0 Bid Award <br />F-1 Quote Award <br />F-1 C/O & PCA No <br />F-1 Traffic Control <br />Farerarem. <br />1011011MMZ <br />■ PCA <br />Resolutior. <br />0 Title Sheet <br />E] Yes F-1 If Yes, Approved by Purchasing <br />0 No <br />E]❑ MBE Completed E-VeriEl Nis <br />fy Form Attached E El <br />Amount of ❑ increase $ <br />❑ Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: <br />Time Extension: <br />