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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 3/15/23 Department Fire <br />BPW Date 3/28/23 Phone 9255 <br />Name Carl Buchanon, Fire Chief <br /> Required Prior to Submittal to Board Legal Attorney Name <br />Controller <br />Controller review is required for all Contracts $5,000.00 or more <br />and greater than one year in length per the City Purchasing <br />Policy <br />Purchasing <br />Check the Appropriate Item Type – Required for All Submissions <br /> Agreement Contract Proposal Addendum <br /> Claim <br /> Bid Opening Bid Award Req. to Advertise Title Sheet <br /> Quote Opening Quote Award <br /> Chg Order No. C/O & PCA No. PCA <br /> Ease./Encroach. Traffic Control Resolution <br /> Other: <br />Required Information <br />Company or Vendor Name <br />New Vendor Yes No If Yes, Approved by Purchasing <br />MBE/WBE Contractor MBE WBE <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount $ <br />Terms of Contract <br />Purpose/Description Disposal of Unfit Property-Helmet and Boots-Retiree Eric <br />Devereaux <br />For Change Orders Only <br />Amount of <br /> <br />Increase <br />Decrease <br />$ <br />$ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />PO No. <br />Dispersal After Approval <br />Copy Original <br /> <br /> <br />