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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 10/18/2018 <br />Department VPA: Facilities & <br />Name Patrick Sherman Grounds <br />BPW Date 10/23/2018 Phone Extension 5601 <br />Required Prior to Submittal to Board' <br />Le,gall Z Attorney Name Clara McDaniels <br />Controller Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing <br />Z Michael Schmidt <br />LJ Agreement H Contract LJ Proposal LJ Addendum <br />El Professional Services 0 Resolution <br />F-1 Bid Opening F1 Bid Award Req. to Advertise El Title Sheet <br />F] Quote Opening F] Quote Award <br />Change Order No. E] C/O & PCA No. ❑ PCA <br />❑ Ease/Encroach. ❑ Traffic Control <br />Other: QPA Purchase <br />Company or Vendor Name Gametime <br />New Vendor F-1 Yes 0 No El If Yes, Approved by Purchasing <br />MBENVBE Contractor n MBE F1 VVBE <br />MBE/VVBE Contractor Requested [:] No [:] Yes Name of Company <br />Project Name Park Warades Program <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of <br />1076-2018 <br />Park Bond Series 1 <br />471-1137-452.42-01 <br />$ 189,197.49_ <br />QPA Purchase: US Communities Contract #2017001134 <br />QPA Purchase of playground equipment as part of park upgrades <br />program to take advantage of grant funds available. <br />F-1 Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination. Non -Debarment, E-Verifv. Iran, etc.) <br />Increase $ <br />El Decrease <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Copy Original <br />F-1 F-1 <br />El 1-1 <br />El 11 <br />Dispersal After Approval <br />