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Date <br />BPW Date <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Spetember 30, 2011 Department _C&ED <br />October 3, 2011 Phone 235-5842 <br />Name Bill Schalliol <br />Legal Attorney Name L. Meteiver <br />7: E, Controller review is required for all Contracts $5,000.00 or more <br />Controller and greater than one year in length per the City Purchasing <br />in Policy <br />Other Appropriate Reviewers F1 <br />Amount of <br />.......... ..... <br />Agreemi-nt <br />Li <br />C <br />$ <br />2 <br />LJ <br />Addendum <br />% <br />Claim <br />$ <br />❑ <br />Bid Opening <br />PO No. <br />Bid Award <br />Req. to Advertise <br />Title Sheet <br />Quote Opening <br />Quote Award <br />❑ <br />Ch g Order No. <br />LJ <br />C/O & PCA No. <br />PCA <br />[_1 <br />Ease./Encroach. <br />7—Traffic <br />Control <br />El <br />Resolution <br />❑ <br />Other: <br />Amount of <br />❑ <br />❑ <br />Increase <br />I Decrease <br />1$ <br />$ <br />Previous Amount <br />$ <br />-Current Percent of Change: <br />% <br />New Amount <br />$ <br />Total Percent of Change: <br />% <br />PO No. <br />RARIN <br />Copy Original <br />1:1 Z Daryl Knip, Abonmarche <br />z ❑ Bill Schalliol, CED; John Engstrom, Engineering; Chief Buchannan, Fire <br />