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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />7/30/2019 <br />Kieran Fa <br />Department Public Works <br />BPW Date 8/13/2019 Phone Extension 5993 <br />Reauired Prior to Submittal to Board <br />Legal ® Attorney Name <br />Clara McDaniels <br />Controller ❑ Controller review is required for all Contracts $5,000.00 or more anc <br />greater than one year in length per the City Purchasing Policy <br />Purchasing <br />Check the', <br />E] Agreement <br />® Professional Services <br />❑ Bid Opening <br />❑ Quote Opening <br />❑ Change Order No. <br />E] Ease/Encroach, <br />F Other: <br />LJ Contract <br />❑ Resolution <br />El Bid Award <br />[l Quote Award <br />❑ C/O & PCA No. <br />❑ Traffic Control <br />Company or Vendor Name: Stantec Consulting Services <br />for All Sul <br />➢ Proposal <br />❑ Req. to Advertise <br />❑ PCA <br />Addendum <br />❑ Title Sheet <br />New Vendor ❑ Yes ® No ❑ If Yes, Approved by Purchasing <br />MBE/WBE Contractor ❑ MBE F-1 WBE <br />MBE/WBE Contractor Requested ❑ No E] Yes Name of Company <br />Project Name LTCP reneptiation <br />Project Number 117-056.7 <br />Funding Source Wastewater Professional Servicn ineerin L.�TCP) � ... __ _mm.__�.___ ....................�- __ _______ <br />AccountNo. 641-0630-793-3201 .... Amount.......�....2.00.'.00.0.............................................................._..........._.................�........................................�...................................�................. <br />................... <br />Terms of Contract..__.............Notmto exceed the mabove.....amount......................................................................................................................................._ <br />Purpose/Description Fo.............r rene otiation of new LTCP <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination. Non -Debarment, E-Verifv. Iran, etc.) <br />Amount of ❑ Increase <br />❑ Decrease $ <br />