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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 12/3/19 <br />Name Site Gerlach Department IT <br />BPW Date 12/10/19 Phone Extension 6209 <br />u�wo� <br />r,1 on �da�� ��,��m, ���� �b ��� mo����m�����������������������������w��������a�� <br />............ ......- <br />RCQUired Prior to Submittal to Board <br />BPW Attorney Attorney Name Clara Daniels --_... <br />Dept. Attorney Attorney Name Sandra Kennedy <br />Purchasing ® Michael. Schmidt <br />Check the Appropriate Item Type _.-- <br />L Professional Services Agreement E] Contract <br />Open Market Contract ❑ Amendment/Addendum <br />Bid Opening ❑ Bid Award <br />❑ <br />Quote Opening ❑ Quote Award <br />Proposal Opening F-1 C/O & PCA No. <br />Chg. Order, No. EJ Traffic Control <br />Other: HP Lease Scliedule <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 />L J Proposal <br />❑ Special Purchase, QPA <br />Req. to Advertise <br />Reject Bids/Quotes <br />PCA <br />Resolution <br />❑� Ease./Encroach <br />Hewlett Packard <br />❑ Yes, If Yes, Approved by Purchasing <br />® No <br />❑ Title Sheet <br />For Chat Orders Qty <br />Amount of ❑ <br />Increase $ <br />❑ <br />Decrease ($ ) <br />Previous Amount <br />$ <br />Increase <br />/o <br />Current Percent of Change: <br />Decrease <br />) <br />New Amount <br />$ <br />Increase <br />% <br />Total Percent of Change: <br />Decrease <br />o) <br />Time Extension Amount: <br />New Comoletion Date: <br />