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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 4/23/2018 Department Fire <br />BPW Date 5/8/2018 Phone 9255 <br />Name Stephen Cox, Fire Chief <br />o Legal ❑ Attorney Name <br />o i� Controller review is required for all Contracts $5,000.00 or more <br />o Controller ❑ and greater than one year in length per the City Purchasing <br />a a m° Policy <br />Purchasing ❑ <br />Chick flee A ropria#e Item Ty e �- Re uirecl for All Submissions <br />1] Aareement I I-1 Contract I F] Proaosal I F] Addendum <br />❑ <br />Claim <br />❑ <br />Bid Opening <br />I ❑ <br />Bid Award <br />❑ Req. to Advertise <br />❑ <br />Title Sheet <br />L] Quote Opening Lj Quote Award <br />❑ Ch Order No. ❑ CIO & PCA No. ❑ PCA <br />❑ Ease./Encroach. ❑ Traffic Control ® Resolution <br />n Other: <br />Company or Vendor Name <br />New Vendor <br />❑ <br />Yes 0 No ❑ If Yes, Approved by Purchasing <br />MBEIWBE Contractor <br />❑ <br />MBE ❑ WBE <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />$ <br />Terms of Contract <br />Purpose/Description <br />Disposal of Unfit/Obsolete property; retirees J. Luccki, D. <br />Maenhout K. Noel] <br />Amount of ❑ Increase $ <br />Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />PO No. <br />Dispersal After Approval <br />Copy Original <br />❑ ❑ <br />