Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 3/19/19 <br />Department Public <br />Name Becca Plantz Works <br />BPW Date 3/12/19 Phone Extension 5998 <br />immmmim�muw�aae reaurwwaw. ua�,muuuc ww � PPPPMPm0000mmmmmmmmmmmmmmum mu�"flii lNffpp M <br />q!lirSd to Submittal to Board <br />BPW Attorney ® Attorney Name Clara McDaniels <br />Dept. Attorney Attorney Name <br />.... _..... _ _ _......... <br />Purchasing F <br />Check the Appropriate Item Type _.. <br />❑ Professional Services Agreement ❑ Contract <br />Open Market Contract <br />M Amendment/Addendum <br />Bid Opening <br />❑ Bid Award <br />Quote Opening <br />E Quote Award <br />Proposal Opening <br />❑ C/O & PCA No. <br />❑ Chg. Order, No. <br />❑ Traffic Control <br />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 />H Special Purchase, QPA <br />Req. to Advertise <br />Reject Bids/Quotes <br />® PCA <br />❑ Resolution <br />Ease./Encroach <br />Peerless Midwest <br />Yes If Yes, Approved by Purchasing <br />No <br />❑ Title Sheet <br />For Change <br />Orders mOnly_IT mmu <br />Amount of <br />Increase $ <br />[� <br />Decrease ($ <br />Previous Amount <br />$ <br />..�.Increase..................................................w�.�_ <br />°__...,_..............................................�����.....�..�.�..�.. �............................................_ <br />/o <br />..... <br />Current Percent of Change: <br />Decrease <br />_......._dada_ <br />( %) <br />New Amount <br />$ <br />Increase <br />/o <br />Total Percent of Change: <br />Decrease <br />%) <br />Time Extension Amount: <br />New Completion Date: <br />