Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date September w17,w2019 <br />Name Jeff Hudak <br />Department Central Services <br />...:.. <br />r. BPWD,Yateeptemb,er ,24, 2019y� A F� _��---Phone Extension 574-235 9316 <br />Required Prior to Submittal to Board <br />Legal Attorney Name Clara McDaniels <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller ] and greater than one year in length per the City Purchasing <br />Policy <br />Purchasing <br />Check the <br />L— J Agreement <br />Professional Services <br />Bid Opening <br />Quote Opening <br />[� Chg Order No. <br />El Ease./Encroach. <br />n Other: <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 />Michael Schmidt <br />)riate Item Type <br />qJ Contract <br />Amendment <br />iced for All Submissions <br />Proposal <br />n Bid Award ® Req. to Advertise <br />E] Quote Award <br />El C/O & PCA No. ❑ PCA <br />] Traffic Control 0 Resolution <br />0 Claim <br />Rea u i red...Information <br />...........�w�wwv,.,�.��.�mw...........m._. �......m.__... <br />Yes U If Yes, Approved by Purchasing <br />No <br />Addendum <br />❑ Title Sheet <br />MBE Completed E-Verify Form Attached El Yes <br />] WBE [:] No <br />Spec U — One (1) Or More 2019 or Newer Single Axle Stainless <br />Steel Multi -Use Dump Truck <br />Street Department Capital Lease & Interest <br />_...._..._._ ...._—._._._......_.� ................... ... <br />202-0607-431.38.01 & 202-0607 431 38.02 <br />Opening Bid Date: October 22, 2019 <br />Fermag�e �dd�s 1....w._... _.�._.mm__�n ................_.�..u�.. <br />Amount of ❑ Increase <br />] Decrease $ <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Time Extension: <br />Dispersal After Approval <br />Copy <br />Original <br />® <br />❑ Jeff Hudak <br />® <br />� ...�.........................................— <br />Terri Swift <br />®Sean <br />Ward <br />