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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 11/21/17 <br />Department VPA: Facilities and <br />Name Patrick Sherman Grounds <br />BPW Date 11/27/17 Phone Extension 5601 <br />fflfl�=W 1111M <br />Required Prior to Submittal to Board <br />.......... . . ...... <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 />LJ Agreement <br />Professional Services <br />Bid Opening <br />Quote Opening <br />Change Order No. <br />Ease/Encroach. <br />F-1 Other: <br />M Michael Schmidt <br />)r9priate Item Type - <br />Contract <br />❑ Resolution <br />El Bid Award <br />El Quote Award <br />F] C/O & PCA No. <br />El Traffic Control <br />n <br />Company or Vendor Name TBD <br />for All Sul <br />Proposal <br />Z Req. to Advertise <br />rmation <br />El PCA <br />New Vendor El Yes E] No E] If Yes, Approved by Purchasing <br />MBENVBE Contractor F-1 MBE FI WBE <br />MBEANBE Contractor Requested E] No F-1 Yes Name of Company <br />Project Name Venues Parks & Arts 2019 Chemical Supply <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of <br />Previous Amount <br />l..078-2018 <br />...... . . . . ...... . <br />Various VPA Maintenance funds <br />Various VPA Maintenance accounts <br />TBD <br />Addendum <br />E] Title Sheet <br />Agreed upon cost as needed bar departments <br />Creating agreement for grounds and qolf chemicals to be purchased <br />as needed throw hoot 2019 <br />M Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Ve_1 , tc.) <br />rt�_Irani <br />— — -F _ <br />R�eau­ired or Change Orders Only <br />.......... <br />increase <br />Decrease <br />. ........... <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Dispersal After Approval <br />Copy <br />Original <br />F-1 <br />F-1 <br />D <br />El <br />