Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date April 8, 2020 <br />Department Public <br />Name Scott Kreeger Works <br />BPW Date April 14, 2020 Phone Extension 9245 <br /> <br />Required Prior to Submittal to Board <br />BPW Attorney Attorney Name Clara McDaniels <br />Dept. Attorney Attorney Name <br /> <br />Purchasing Michael Schmidt <br />Check the Appropriate Item Type Required for All Submissions <br /> Professional Services Agreement Contract Proposal <br /> Open Market Contract Amendment/Addendum Special Purchase, QPA <br /> Bid Opening Bid Award Req. to Advertise Title Sheet <br /> Quote Opening Quote Award Reject Bids/Quotes <br /> Proposal Opening C/O & PCA No. PCA <br /> Chg. Order, No. Traffic Control Resolution <br /> Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name <br /> Yes If Yes, Approved by Purchasing <br />New Vendor <br /> No <br /> MBE Yes <br />MBE/WBE Contractor Completed E-Verify Form Attached <br /> WBE No <br />Project Name 2020 Street and Sewer Department Materials <br />Project Number 120-005 <br />Streets, Curb & Sidewalk, Sewer Concrete, Sewer Ins, Water Works, <br />Funding Source <br />Parks, MVH-Restricted <br />202-0607-431.22-24, .22-30, .22-40, .23-02, .23-03, 23-20, 23-40, .39-89, <br />641-0621-792.22-24, .23-02, .23-03, .23-04, 202-0619-431.23-03, .23-24, <br />641-0625-792.22-24, .23-04, 640-0620-811.22-24, .23-04, 620-0640- <br />606.23-30, 201-1101-452.39-89 (Proj Code K61RMT), 266-0607-431.22- <br />Account No. 30, 266-0607-431.23-02 <br />Amount <br />Terms of Contract Unit Price <br />Purpose/Description ____________________________________________________________ <br />For Change Orders Only <br />$ <br /> Increase <br />Amount of <br /> Decrease ($ ) <br />Previous Amount $ <br /> % <br />Increase <br />Decrease ( %) <br />Current Percent of Change: <br /> <br />New Amount $ <br /> % <br />Increase <br />Decrease ( %) <br />Total Percent of Change: <br /> <br />