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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 4/17/19 . ............... . . ................. . . Department <br />Fire <br />� i I BPW Date 19 Phone 9255 <br />Name Stephen Cox, Fire Chief <br />100999MMMNM I <br />0 Legal F] Attorney Name Elliot Anderson, Clara McDaniels <br />0 <br />CZ 72 <br />o m Controller <br />a) <br />U) Purchasing <br />Check the A <br />8�gree�m�ent <br />Claim <br />Bid Op ning., Quote Opening <br />Chg Order No. <br />Ease./Encroach. <br />. . ................. __ <br />Other: <br />Company or Vendor Name <br />New Vendor <br />MBEIWBE Contractor <br />Project 19,me <br />Project _ 'Y'­MbeT........ <br />Funding Sq!4_rq_ <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <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 />�ropriate Item Type — Required for All Submissions <br />F1 <br />I F Contract Proposal -1 Addendum <br />Bid Award <br />Quote Award <br />C/O & PCA No. <br />Traffic Control <br />uired Information <br />Req. to Advertise_j <br />PCA <br />Resolution 1(,n- <br />Yes Lj No Lj If Yes, Approved by Purchasi <br />MBE F-1 WBE <br />Title Sheet <br />Disposal of Unfit Obsolete Property --Helmet and Boots for <br />Retiree Firefighter.Mark James <br />hanae Orders Onlv <br />Amount of [:] Decrease !P $ <br />F] � increase ' 6* <br />j_ <br />Previous Amount $ <br />Current Percent of Chang_eL. % <br />New Amount $ <br />Total Percent of 6kan­ % <br />PO No. <br />Dispersal After Approval <br />Copy Original <br />