Laserfiche WebLink
BOA14,I) OF P`UBI,IC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 4-19-2018 <br />Department Utilities -'Water <br />Name Bradley J. VanOosterum Treatment <br />BPW Date 5-V,2018, Phone Extension 5670 <br />Required Prior to Submittal to Board <br />Legal Attorney Name Clara McDaniels <br />Controller Controller review 'is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />2�•Wljr <br />[_J Agreement <br />L1 Professional Services <br />F-1 Bid' Opening <br />❑ Quote Opening <br />❑ Change Order No. <br />❑ Ease/Encroach. <br />F] Other: <br />Company or Vendor Name <br />LJ Contract <br />El Resolution <br />X Bid Award <br />El Quote Award <br />El C/O & PCA No. <br />F] Traffic Control <br />Z= <br />WMA <br />New Vendor 0 Yes Z No El If Yes, Approved by Purchasing <br />MBEANBE Contractor [] MBE [] WBE <br />MBEANBE Contractor Requested r_1 No [:] Yes Name of Company <br />Project Name Water Treatment Chemicals 2018-2019 <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Various Operational Budgets <br />$ Unit Bid Pricing <br />1: YEAR <br />El Title Sheet <br />Chemical Bid needed to secure competitive pric ng <br />F-1 Required Contractor's Certification Form Attached (Non - <br />Collusion. Non -Discrimination, Noin-Debarment, E-Verifv, Iran, etc. <br />Amount of 0 increase <br />El Decrease <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />42, <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy Original <br />M El Michael Schmidt <br />M F-1 Bradley J. Van Oosterum <br />El El <br />