Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date June 29, 2018 <br />Name Tara Weigand <br />Department <br />Division/Bureau <br />I I 1 01 mylyfln IT <br />Engineering <br />BPVV Date July 10, 2018 Phone Extension, 5998 <br />Required Prior to Submittal to Board <br />Legal ❑ Attorney Name: <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 />Purchasing F-1 <br />H Agreement Amendment <br />E] Professional Services <br />F-1 Bid Opening <br />F Quote Opening <br />F-1 Change Order No. <br />El Ease/Encroach. <br />F Other: <br />Company or Vendor Name <br />H Contract <br />L1 Proposal <br />F1 Resolution <br />El <br />Bid' Award <br />M Req. to Advertise <br />El <br />Quote Award <br />F1 C/O & PCA No. <br />E] PCA <br />M Traffic Control:, <br />Residential Handicap Parking <br />New Vendor <br />MBENVBE Contractor <br />MBEANBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of L_J <br />El <br />E] Title Sheet <br />El Yes El No F1 If Yes, Approved by <br />Purchasina <br />Ll MBE H WBE <br />❑ No � Yes Name of ComDanv <br />1142 E Bissell Street Residential Handicap Parking <br />Recommend <br />H Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Decrease $ <br />Previous Amount $1 <br />Current Percent of Change: % <br />New Amount <br />Total Percent of <br />Dispersal After Approval <br />Copy Original <br />R Roger Nawrot, Assistant City Engineer <br />F1 Ed Gleckler, Manager Bureau of Traffic & Lighting <br />F-1 SBPD <br />