Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 09/16/2019 <br />Department Public <br />Name Zach Hurst Works / EonsgiuEeria <br />BPW Date 09/24/2019 Phone Extension 3057 <br />mummmuuuuuuumumumumuuuuuuv �� �mirxiHi,�r oomm oomm�mmmmm�mm00000000mmmm�mmm�iwi�mmmm ...... <br />lir���it:e,d Prior to Submittal to Board <br />BPW Attorney ❑ Attorney Name <br />Dept. Attorney Attorney Name <br />.— — ........ <br />Purchasing.............................................................................................................................................. <br />Check the Appropriate Item Type -. <br />EJ Professional Services Agreement F-1 Contract <br />El Open Market Contract 0 <br />Amendment/Addendum <br />❑ Bid Opening <br />Bid Award <br />❑, Quote Opening E] <br />Quote Award <br />Ej Proposal Opening <br />C/O & PCA No. <br />Chg. Order, No. <br />Traffic Control <br />❑] Other: <br />Information <br />Company or Vendor Name Office l:ntefiors, Inc. <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />All Submissions <br />Proposal <br />® Special Purchase, QPA <br />E ], Req. to Advertise <br />❑ Reject Bids/Quotes <br />PCA <br />Resolution <br />Ease./Encroach <br />Yes q j If Yes, Approved by Purchasing <br />No <br />❑ Title Sheet <br />MBE <br />MBE Completed E-Verify Form Attached F] Nos <br />Technology Resource Center Fixtures Furnishings, and Equipment <br />119-070 <br />Certified Tech Park Fund <br />439-1050-460-42.02 <br />$4.647.98 <br />OMNIA Partners, Public Sector Contract #P15-150 <br />Amendment 1 to the Agreement for Goods and Services for the subject <br />project. . <br />or Change Orders Only <br />Amount of ❑ <br />Increase $ <br />�� <br />❑ <br />Decrease <br />Previous Amount <br />$ <br />Increase <br />% <br />Current Percent of Change: <br />Decrease <br />............................... .............. �.. <br />( %) <br />New Amount <br />$ <br />Increase <br />Total Percent of Change: <br />Decrease <br />�..........._.%)................................................................................................................._......................�. <br />Time Extension Amount:.. <br />..............................��.__...................... m....... m..___....m........................................ <br />New ComDletion Date: <br />