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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 3/28/19 Department Fire <br />. . .. ..... . <br />BPW Date 4/9/19 Phone 9255 <br />Name Todd Skwarcan, A/C Services <br />lqffi�MINMWHA 90jffiMffl NIMIMM- <br />0 Legal <br />o Controller <br />E m - <br />Of =3 <br />U) Purchasing Z <br />Check the A <br />AgreeT.erjt__ <br />Claim <br />Bid Openi <br />Quote _Oening <br />mm <br />Chq Order No. <br />Ease./Encroach, <br />Otheww <br />r: <br />Attorney Name Elliot Anderson <br />Controller review is required for all Contracts $5,000.00 or more <br />and greater than one year in length per the City Purchasing <br />Policy <br />Michael Schmidt <br />)Tr9Cate <br />Item. Type - Required for All Submissions <br />. . . ................ T []Proposal -rn <br />lontract -A—d de"n—du m' <br />Bid Award <br />Quote Award <br />C/O & PCA No <br />Traffic Control <br />Rdured Information <br />Hastinqs Air Energy <br />Yes No .If Yes <br />F� MBE F-1 WBE <br />to Advertise <br />FCA.- <br />Resolution <br />Purchasin <br />Title Sheet <br />�Capital Improvements/Building Imp <br />rovements <br />287-0902-422-42.02 <br />1 7,935.70 <br />Payment terms: net 30 <br />Design and install -,"Turnkey"—'Plvmovent Vehicle Exhaust <br />Removal System to remove diesel fumes for one armaratus at <br />Station 5, <br />...... ........... ...... . . ... - <br />For Chanci.. e Orders Only <br />F-1 Amount of Increase❑ <br />$ <br />.................. A <br />Previous Amount <br />Current Percent of ChaqgqL_, % <br />New Amount $ <br />Total Percent of Change: <br />Z1910 on <br />Dispersal After Approval <br />Copy Original <br />F-1 F' <br />D 0 <br />