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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />2/22/2019 <br />Jeff Hudak <br />Department Central Services <br />BPW Date March 12, 2019 Phone Extension 574-235-9316 <br />,uommnmmurmsv 110 iII 9 Ifflpflflaj n. l .'Wi' W39r WMIIVWIBIVIPrIpflfNIS� kA9 8�'ll�iYlN9rA➢'r Aflfl,�l➢N�"FKKiIIIIII�IIIIII�IIIIIIIIIIIIIIIIIIWI NF.MN�tlf.�' a wvm/.m+m+m�a-mm�' <br />I��airpd Submittal to Board <br />Prior to.....�.....�� , -- <br />Legal Attorney Name Clara McDaniels <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller El and greater than one year in length per the City Purchasing <br />Policy <br />Purchasing Z <br />Check the p <br />L_J Agreement <br />Professional Services <br />® Bid Opening <br />❑ Quote Opening <br />Chg Order No. <br />El Ease./Encroach. <br />F� 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 />Michael Schmidt <br />iropriate Item Type — <br />Contract <br />n Amendment <br />❑ Bid Award <br />❑ Quote Award <br />❑ C/O & PCA No. _ <br />❑ Traffic Control <br />WUN07WITNTIFU <br />for All Submissions <br />.. . <br />Proposal El Addendum <br />® Req. to Advertise ❑ Title Sheet <br />❑ PCA <br />El Resolution <br />n Claim <br />U' Yes Ll If Yes, Approved by Purchasing <br />No <br />❑ MBE Completed E-Verify Form Attached Yes <br />❑ WBE �❑ No <br />Spec B — Two (2) more or less 2018 or newer27 Cubic Yard <br />Single Arm Side Loading Refuse Trucks <br />(Solid Waste) Lease Purchase id <br />Principle: 611-0610-4.1..5-3.............. ........................8 <br />- 801 Interest:611-0610-415-3802 <br />Opening Bid Date: April 9, 2019 <br />�.......��_, .�.ew.. � ... .....w�For �� Orders Only <br />rease <br />Amountof ,..�._............................................_......._ <br />Decrease _.._................................._ <br />_........................................M .. <br />Previous Amount $ <br />Current Percent of Change: %�....._. .............................�� _�..._..................� <br />NewAmount...t..........................�w....._...� .............._............_._ _.._..._......�.....___...._. <br />........_ W_.. _._ _............................. ............ <br />Total Percent of Change: % <br />Time Extension: <br />Dispersal After Approval <br />Copy Original <br />® ❑ Jeff Hudak <br />® ❑ Kell ........ �� ___..............................�.�... <br />y Smith&Susan Zeeb �.... __W..._ <br />...�.�.�......_.... <br />® El__�- .... <br />Al Greek <br />