Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />Auaust 17. 2020 <br />Maricela Juarez <br />Department Admin & Finance <br />BPW Date 08/25/2020 Phone Extension 9953 <br />MPHIPMIIIIIIIIIIIIIIIillillilillillilimmmmmmmmmm u momomoan0000000m^�mPPPMMmmmmtmui vufom ommmmmmmmmMMMMEMENnm rrramNinimmm <br />Required Proo­6—---"-'— bmiftaI to Board <br />Legal Attorney Name <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller El and greater than one year in length per the City Purchasing <br />Policy <br />Purchasing ❑ <br />Check the P <br />Agreement <br />Professional Services <br />wO riate Item Type - <br />El Contract <br />0 Amendment <br />for All Submissions <br />. — . . . ......... <br />Proposal El Addendum <br />E] Bid Opening F-1 Bid Award E] Req. to Advertise El Title Sheet <br />F-1 Quote Opening F] Quote Award <br />❑ Chg Order No. n C/O & PCA No. ❑ PCA <br />Ease./Encroach. F-1 Traffic Control E] Resolution <br />Z Other: Disposal/Scrap El Claim <br />2020 Central Services <br />Auction <br />........ .. . . . .... <br />Required Information <br />Company or Vendor Name <br />New Vendor <br />El Yes El If Yes, Approved by Purchasing <br />F-1 No <br />MBE/WBE Contractor <br />❑ MBE Completed E-Verify Form Attached <br />WBE <br />0: <br />Yes <br />No <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />IT For Change Order§ ly <br />Amount of F] increase — — - — ------------------ - <br />[-] Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />Time Extension: <br />Copy <br />Original <br />Z <br />F-1 <br />F-1 <br />El <br />El <br />F-1 <br />Dispersal After Approval <br />Maricela Juarez <br />