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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />BPW Date <br />5/23/2018 <br />6/12/2018 <br />Name Stephen Cox, Fire Chief <br />Department <br />Phone <br />Fire <br />9255 <br />o Legal ❑ Attorney Name Elliott Anderson <br />a o Controller review is required for all Contracts $5,000.00 or more <br />Controller ❑ and greater than one year in length per the City Purchasing <br />m Policy <br />U) Purchasing ❑ Michael Schmidt <br />Check the Appropriate Item Type Required for All Submissions <br />❑ <br />A reement <br />❑ Contract I <br />❑ Proposal <br />❑ Addendum <br />❑ <br />Claim <br />❑ <br />Bid Opening <br />❑ <br />Bid Award <br />❑ Req. to Advertise <br />I ❑ Title Sheet <br />❑ <br />Quote Opening <br />❑ <br />Quote Award <br />❑ <br />Chg Order No. <br />❑ CIO & PCA No. <br />❑ PCA <br />Resolution 9w <br />❑ <br />Ease./Encroach. <br />❑ Traffic Control <br />❑ <br />Other: <br />Company or Vendor Name <br />New Vendor <br />❑ <br />Yes El <br />No ❑ If Yes, Approved by Purchasing <br />MBEIWBE Contractor <br />❑ <br />MBE ❑ WBE <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />$ <br />Terms of Contract <br />Purpose/Description <br />Disposal of Unfit Property/Helmets & Boots: retirees: D. Blake <br />M. Humes, J. Riba <br />Amount of <br />❑ <br />❑ <br />Increase $ <br />Decrease $ <br />Previous Amount <br />$ <br />Current Percent of Changer <br />% <br />New Amount <br />$ <br />Total Percent of Change: <br />% <br />PO No. <br />Dispersal After Approval <br />Copy Original <br />❑ ❑ <br />❑ ❑ <br />