Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />11/13/2018 <br />Shirk <br />Department Admin & Finance <br />BPW Date 11/27/2018 Phone Extension 9133 <br />. . . .............. . ...... <br />Required Prior to Submittal to Board <br />Legal Attorney Name <br />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 />Policy <br />Purchasing <br />Check the P <br />LJ Agreement <br />F-1 Professional Services <br />F-1 Bid Opening <br />Quote Opening <br />Chg Order No. <br />❑ Ease./Encroach. <br />Other: Disoos,al <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />irqp�riate Ite <br />--.Lqm�T e�-R �yireq for All Submissions <br />El Contract El P"ro'posal Addendum <br />EJ Amendment <br />R Bid Award Req. to Advertise El Title Sheet <br />El Quote Award <br />El C/O & PCA No. RQ-A <br />El Traffic Control Resolution POP <br />Claim <br />Information <br />1:1J Yes F] If Yes, Approved by Purchasing <br />[:] No <br />F� MBE Completed E-Verify Form Attached El Yes <br />[:1 WBE EJ No <br />Amount of El increase $ <br />F] Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />Time Extension: <br />Dispersal After Approval <br />Copy <br />Original <br />❑ <br />El <br />D <br />El <br />0 <br />El <br />