Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 3/14/19 <br />Department <br />Name Michelle Smith Utilit NVater Works <br />BPW Date 3/26/19 Phone Extension 5994 <br />e� uircci Prior to Submittal to Board <br />BPW Attorney ® Attorney Name Sandra ilwednlned <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ❑ <br />Check the 't o rite Item Te - �c��14 <br />Professional Services Agreement Contract <br />�] Open Market Contract El Amendment/Addendum <br />❑ Bid Opening El Bid Award <br />E] Quote Opening ❑ Quote Award <br />E] Proposal Opening ❑ C/O & PCA No, <br />R Chg. Order, No. ❑ 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 />u ired Information <br />EnviroSolutions <br />Yes <br />No <br />d fin- All Submissions <br />Proposal — <br />l Special Purchase, QPA <br />El Req. to Advertise ❑ Title Sheet <br />❑ Reject Bids/Quotes <br />PCA <br />❑ Resolution <br />F-1 Ease./Encroach <br />It Yes, Approved by Purchasing <br />❑ MBE Completed E-Verify Form Attached ® Yes <br />WBE ❑ No <br />Water Works 2019 Semiannual Groundwater Sampling and <br />ReportingProposal #2-3284-19 <br />Water Works O eratina Fund <br />620.0640.602.31.06 <br />.......... _....... <br />Purpose/Description Groundwater sam lin at severaN of our monitorin wells surroundin <br />wellfields where they is a contamination concern. Also a survey of <br />the monitorinq wells around South Station fora Iroundwater flow ma . <br />��� For Cl:�ao Orders Ont <br />Amount of � Increase $ <br />Decrease ($ ) <br />Previous Amount <br />$ <br />Increase <br />% <br />Current Percent of Change: <br />Decrease <br />( % <br />New Amount <br />$ <br />Increase <br />Total Percent of Change: <br />Decrease <br />( % <br />Time Extension Amount: <br />New Completion Date: <br />