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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 9/9/2019 <br />Department <br />Name Herschel La pan Innovation & Tech <br />BPW Date 9/24/19 Phone Extension 9145 <br />�o iei��omomomomomomo ' rae,�mnu�w�ur�aiww�rcwarmr�a a . ,. w murvnrwmrmum�memw�iunrrmu�aiwnnw,�¢reu�c��uvmr�ra�^iwr�s��rn� m�aem�mmumu�orare� <br />w..... -._. Required Prior to Submittal to Board <br />BPW Attorney " Attorney Name McDaniels <br />Dept. Attorney >< Attorney Name Kennedy <br />Purchasing E Schmidt <br />Check the Appropiate Item Type — Reg�� <br />❑ Professional Services Agreement 0 Contract <br />�❑ Open Market Contract [-j Amendment/Addendum <br />E] Bid Opening ❑ Bid Award <br />Fj Quote Opening ❑ Quote Award <br />R Proposal Opening ❑I C/O & PCA No. <br />E] Chg. Order, No. ❑ Traffic Control <br />E Other: Hardware Lease <br />Company or Vendor Name <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 />Information <br />All Submissions <br />Proposal <br />Special Purchase, QPA <br />Req. to Advertise <br />Reject Bids/Quotes <br />PCA <br />❑ Resolution <br />Ease./Encroach <br />❑ Title Sheet <br />AT&T Mobility <br />❑ Yes❑ If Yes, Approved by Purchasing <br />® No <br />MBE [� WBE Completed E-Verify Form Attached Nos <br />Mobile Tablet Lease <br />IT Lease Accounts <br />279-0672-415.38-01 rincial and 38-02 interest <br />$9,958.75 <br />36 months <br />iPad lease for Utilities and Public Works <br />Amount of F] <br />Increase _�.,$..._���..........�........�.�.�.�.�.�.�.�.� <br />.�.�._� ............................ �.........�........._ <br />Decrease <br />�� <br />Previous Amount <br />$ <br />Increase <br />% ..................................................................���.........................................................�.� <br />Current Percent of Change: <br />Decreasea�.%) <br />New Amount <br />$ <br />Increase <br />Total Percent of Change: <br />Decrease <br />............. <br />Time Extension Amount: <br />New Completion Date: <br />