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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date April 18, 2018 <br />Name Scott Kreeger <br />Department <br />Division/Bureau <br />0101 nylyfel I <br />Engineering <br />BP,W Date April 24, 2018 Phone Extension 9245 <br />Required Prior to Submittal toBoard <br />Legal F-1 Attorney Name: Clara McDaniels <br />Controller ❑ <br />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 El <br />F-1 Agreement Amendment <br />LJ <br />Contract L] Proposal LJ Addendum <br />F1 Professional Services <br />El <br />Resolution <br />F-1 Bid Opening <br />M <br />Bid Award El Req. to Advertise El Title Sheet <br />[] <br />Quote Opening <br />El <br />Quote Award <br />F-1 <br />Change Order No. <br />0 <br />C/O & PCA No. ❑ PCA <br />❑ Ease/Encroach. <br />F-1 <br />Traffic Control: <br />Other: <br />Company or Vendor Name <br />New Vendor <br />MBENVBE Contractor <br />MBENVBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Multiple <br />El Yes Z No El If Yes, Approved by Purchasing <br />aMBE E:1 WBE <br />F-1 No El Yes Name of Company <br />2018 Streets and Sewers Department Materials <br />118-031 <br />Streets, Curb & Sidewalk, Sewer Concrete, Sewer Ins, Water Works, <br />Parks <br />202-0607-431.22-24, 22-30, .22-40, .23-02, .23-03, 23-201, 23-40, .39- <br />89, 641-0621-792.22-24, .23-02, .23-03, 23-04, 202-01619-431.23-03, <br />.23-24, 641-0625-792.22-24,.23-04, 640-0620-811.22-24, .23-04, <br />620-0640-60623-30, 201-1101-452.39-89 (ProJ. Code K61 RMT) <br />Terms of Contract Unit Price <br />Purpose/Description Purchase of materials for Street and Sewer Departments. <br />Award Divisions A, B, and E <br />Reject C, D, F thru H <br />n Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Reou,ifed'For 0has 'jo',Orders-Only, <br />, ra ers <br />Amount of ❑ <br />increase - $ <br />E] Decrease $ <br />Previous Amount $ <br />Current Percent of Change: 0/0 <br />New Amount $ <br />Total Percent of Change: % <br />Dispersal After Approval - - -- ---- ------- <br />I41 <br />,= ON. <br />01. &ara i5oyies, <br />M n Roger Nawrot <br />