Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />4/02/2019 <br />Jeff Hudak <br />Department Central Services <br />BPW y 142019 ens5- <br />Date May , Phone Extension 74-2359316 <br />�� 07 �HPMMMMMMMMMM r=#,= <br />. ............ <br />,._....-Required wPrior to Submittal to Board <br />�6 <br />Legal Attorney Name Clara McDaniels <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller ❑ and greater than one year in length per the City Purchasing <br />Policy <br />Purchasing <br />Check the A <br />LJ Agreement <br />❑ Professional Services <br />Bid Opening <br />F] Quote Opening <br />E] Chg Order No. <br />E! Ease./Encroach. <br />Other: <br />Company or Vendor Name <br />New Vendor <br />MBE/MBE 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 T ems— Required for All Submissions <br />.. ......... <br />Contract ❑ Proposal <br />[ Amendment <br />Bid Award ® Req. to Advertise <br />El Quote Award <br />[:] C/O & PCA No. PCA <br />E] Traffic Control Resolution <br />Claim <br />Required Information <br />Addendum <br />❑ Title Sheet <br />Yes ❑ If Yes, Approved by Purchasing <br />jE] No <br />MBE Completed E-Verify Form Attached El Yes <br />WBE ❑ No <br />Spec L — One (1) or More 2019 or Newer Full Size 8-Passanger <br />Van <br />2019 Fire Department Capital Budget <br />287-0902-422-43-02 w <br />Opening Bid Date: May 14, 2019 <br />... m For change firers rWq.... <br />Amountof <br />� Increase <br />..... .. ............................ww..._- <br />❑ Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />Time Extension: <br />Dispersal After Approval <br />Copy Original <br />® ❑ Jeff Hudak <br />® ❑ Todd Skwamrcan <br />