Laserfiche WebLink
Date <br />Name <br />BOARD OF PUBLIC WORDS <br />AGENDA ITEM REVIEW REQUEST FORM <br />1 19, 2018 <br />Jacob M. Klosinski <br />Department Utilities - Wastewater <br />Purchasing ® Al Greek, Director of Utilities <br />H Agreement <br />Lj Contract <br />❑ Proposal ❑ Addendum <br />❑ Professional Services <br />❑ Amendment <br />❑ Bid Opening <br />❑ Bid Award <br />❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening <br />❑ Quote Award <br />❑ Chg Order No. <br />❑ CIO & PCA No. <br />❑ <br />PCA <br />❑ Ease./Encroach. <br />❑ Traffic Control <br />❑ <br />Resolution <br />® <br />Other: Relect Quotes <br />❑ <br />Claim <br />Company or Vendor Name <br />New Vendor <br />MBENVBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />® No <br />❑ WBE Completed E-Verify Form Attached ❑ Nos <br />WastewaterANater Laboratory Equipment ICP-OES <br />nla <br />Utilities, Wastewater, Capital <br />TBD <br />The Division of Utilities is requestinq the Board of Public Works <br />reiect all quotations for the subject protect at the recommendation <br />of the Legal Department. The specification will be revised. The <br />auotation oackaaes will be re -issued at a later date. <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 />Copy <br />Original <br />® <br />❑ <br />® <br />❑ <br />® <br />❑ <br />Dispersal After Approval <br />Al Greek, Director of Utilities <br />Jacob M. Klosinski, Assistant City Engineer <br />Emily Leyes, Director of Financial Services, Environmental Services <br />