HomeMy WebLinkAboutRequest to Advertise - Spec AC - One or More 2018 or Newer 3-4 Ton Extended Cab Four Wheel Drive Pick Up Truckt _ _
T `t 45 ✓
Date
Name
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
9/29/17
Jeff Hudak
Department Central Services
BPW Date 10/10/17 Phone Extension 574-235-9316
❑ Agreement
Contract L Proposal L Addendum
❑ Professional Services
❑
Resolution
❑ Bid Opening
❑
Bid Award ® Req. to Advertise ❑ Title Sheet
❑ Quote Opening
❑
Quote Award
❑
Change Order No.
❑ CIO & PCA No. ❑ PCA
❑
Ease/Encroach.
❑ Traffic Control
f-1
Other:
Company or Vendor Name
New Vendor
MBE/WBE Contractor
MBE/VVBE Contractor
Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Amount of L- J
El
❑ Yes ❑ No ❑ if Yes, Approved b Purchasin
❑ MBE ❑ WBE
❑ No ❑ Yes Name of Company
Spec AC — One (1) or more 2018 or Newer % Ton Extended Cab
Four Wheel Drive Pick Ur) Truck
Previous Amount $
Current Percent of Change: %
New Amount $
Total Percent of Change: %
Dispersal After Approval
Copy
Original
®
❑ Jeff Hudak & Sheila Enos
®
❑ Darric Cole & Roxanne Lawson
❑
❑