HomeMy WebLinkAboutRequest to Advertise - City Wide Curbside Recycling ServicesDate
Name
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
02/14/2017
Department Sustainability
BPW Date 02/14/2017 Phone Extension
Required Prior to Submittal to Board
Legal Attorney Name
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
Therese Dorau
Purchasing ❑
Check the A
Agreement
Professional Services
Bid Opening
Quote Opening
Chg Order No.
Ease./Encroach.
Other:
Company or Vendor Name
New Vendor
MBE/WBE Contractor
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Addendum
❑ Bid Award ® Req. to Advertise ❑ Title Sheet
❑ Quote Award
❑ C/O & PCA No. ❑ PCA
❑ Traffic Control ❑ Resolution
❑ Claim
Required Information
El Yes ❑ If Yes, Approved by Purchasing
❑ No
❑ MBE Completed E-Verify Form Attached El Yes
❑ WBE ❑ No
City -Wide Curbside Recycling Services
Solid Waste Recycling Services
For Chanqe Orders O
Amount of
Increase
Dec
Previous Amount
Current Percent of Change:
New Amount
Total Percent of Change:
Time Extension:
Dispersal After Approval
Copy
Original
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