QPA Special Purchase - Phoenix Safety Outfitters - Body Armor for SBFD

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date Jul 20 ....... ... Name Andrew, M er Department Fire BPW Date Au ' past +6 2019 Phone Extension 7562 oWMMWHMIM miMMIImmm! �N .... . ...... .1PGwmmmiwuwuwN„Hx ate, o mmweE . xx .. anw�,airr e rrr ea rwuw rr or+wren¢��r n aemamwmnv ..........._.................�...... . _. _... _......... ._......... — ------- Required Prior to Submittal to Board BPW Attorney Attorney Name Dept. Attorney x❑ Attorney Name Elliot Anderson Purchasing X❑ Michael Schmidt: __._. _..W.._ Check the Appropriate Item Type — , equirelj6r All Submissions Professional Services Agreement ❑ Contract R Open Market Contract F] Amendment/Addendum R Bid Opening E] Bid Award ❑ Quote Opening Quote Award ❑j Proposal Opening ❑ C/O & PCA No. Chg. Order, No. ❑ Traffic Control ❑] Other: Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description uired Information U Proposal X❑ Special Purchase, QPA ❑ Req. to Advertise ❑ Title Sheel �] Reject Bids/Quotes PCA Resolution Ease./Encroach Phoenix Safet Outfitters ❑ Yes If Yes, Approved ...by...Purchasing .....................................................�.�.�. x❑ No WBE Completed E-Verify Form Attached ❑❑ Nos .. cash n..... 287-0902-422.43-10 Body Armor,4, For Change Orders Only Amount of Increase $ ❑ Decrease Previous Amount $ ..... �w� _____--- _. w ... ..... __ __ ..__.� Increase /o Current Percent of Change: Decrease ( %) New Amount $ ............. Increase % Total Percent of Change: Decrease ^%) Time Extension Amount: New Completion Date: w�— ........................... _._..._.._..... __....��_..,_...............................