Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 10/17/2018 <br />Name Thy _Yi I I a . ... . ..... Department Engineering <br />BPW Date 11/13/2018 Phone Extension 5920 <br />AM- <br />.......... ... <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 <br />.......................... ............ <br />Check <br />F-1 Agreement <br />Ej Professional Services <br />❑ Bid Opening <br />Quote Opening <br />E] Change Order No. <br />n Ease/Encroach. <br />... . .......... <br />ie Appropriate Item Tepee — Re <br />.... . . .. . .... <br />n Contract <br />F-1 Resolution <br />El Bid Award <br />n Quote Award <br />El C/O & PCA No. <br />n Traffic Control <br />Douired Info <br />Proposal <br />El Req. to Advertise <br />Addendum <br />El Title Sheet <br />F-1 Required Contractor's Certification Form Attached (Non - <br />Collusion, Non Discrimination, Non Debarment, E-Verify Iran etc.) <br />Required For Change Orders Only <br />. . . . ................. <br />Amount of r_1 increase $ ................ . . .... <br />El Decrease $ <br />Previous Amount t <br />. ... . ....... <br />Current Percent of Change: % <br />New Amount <br />. . . . . ........... . . ..... <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy <br />Original <br />F] <br />EJ <br />F] <br />El <br />