HomeMy WebLinkAboutRequest for Proposals - VPA Elevator Preventative Maintenance & Service PlanBOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 12/6/16
Name John Martinez
Department Venues, Parks, &
Arts
BPW Date 12/13/16 Phone Extension 235-7645
Required Prior to Submittal to Board
Legal ® Attorney Name Michael Schmidt
Controller review is required for all Contracts $5,000.00 or more
Controller ❑ and greater than one year in length per the City Purchasing
Policy
Purchasing ® George King
Check the Appropriate Item Type — Required for All Submissions
❑ Agreement ❑ Contract ❑ Proposal ❑ Addendum
❑ Professional Services
❑ Bid Opening ❑ Bid Award ® Req. to Advertise ❑ Title Sheet
❑ Quote Opening ❑ Quote Award
❑ Chg Order No. ❑ C/O & PCA No. ❑ PCA
❑ Ease./Encroach. ❑ Traffic Control ❑ Resolution
❑ Other: ❑ Claim
Required Information
Company or Vendor Name
New Vendor
MBE/WBE Contractor
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
U Yes ❑ If Yes, Approved by Purchasing
❑ No
❑ MBE Completed E-Verify Form Attached ❑ Yes
❑ WBE ❑ No
VPA: Elevator Preventive Maintenance and Service Plan
Various- DTSB, Parks, Century Center
Various
2 Years
Elevator Maintenance Agreement
I For Change Orders Only 80;1141 of Pfda;,. wl--f- I
Amount of
Increase
Decrease
Previous Amount
Current Percent of Change:
New Amount
Total Percent of Change:
Time Extension:
Dispersal After Approval
Copy
Original
❑
❑
❑
❑
❑
❑