Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 02/05/2019 <br />Department Public <br />Name wW Zach Hurst Works / EngincernIZ <br />BPW Date 02/12/2019 Phone Extension 3057 <br />Required Prior to Submittal to Board <br />BPW Attorney Attorney Name <br />Dept. Attorney ❑ Attorney Name <br />........................ _�..... <br />Purchasing 0 <br />Check the Appropriate Item Type — <br />p ❑ <br />Professional Services Agreement Contract <br />Open Market Contract Am endment/Addendum <br />❑ Bid Opening ❑ Bid Award <br />❑ Quote Opening ❑ Quote Award <br />Proposal Opening ❑ C/O & PCA No,. <br />Chg. Order, No. ❑ Traffic Control <br />R Other: <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 />Information <br />All Submissions <br />Proposal <br />U Special Purchase, QPA <br />® Req. to Advertise <br />❑ Reject Bids/Quotes <br />PCA <br />Resolution <br />Ease./Encroach <br />❑ Title Sheet <br />El �._._ <br />Yesm If Yes, Approved by Purchasing <br />No <br />MBE Completed E-Verify Form Attached Yes <br />WBE FJ No <br />320 at the Cascade <br />118-074R B <br />River East TIF <br />429-1050-460-42.02 <br />Re uest to advertise for Division B ertainin to the build%n 's External <br />Insulation and Flashing System E FS . <br />......_..... _m_ . <br />For Chat ;e Orders Ool� aEl IT <br />Amount of Increase $ <br />�] Decrease <br />- ...... . <br />Previous Amount <br />Increase <br />% <br />Current Percent of Change: <br />Decrease <br />( % <br />New Amount <br />$ <br />Increase <br />o._._ <br />/o <br />Total Percent of Change: <br />Decrease <br />% <br />Time Extension Amount: <br />New Com-Dietion Date: <br />