HomeMy WebLinkAboutRequest to Advertise - Spec T One or More 2019 or Newer 4X4 Crew Cab Concrete TrucksBOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date
Name
Auaust 5. 2019
Jeff Hudak
Department Central Services
BPW Date Au ust 13, 2019 Phone Extension 574-235-9316
Required Pnor to � Submittal to Board
Legal Attorney Name Clara McDaniels
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
Check the A
LJ Agreement
Professional Services
0 Bid Opening
(] Quote Opening
EJ Chg Order No.
F-1 Ease./Encroach.
F� Other:
Company or Vendor Name
New Vendor
MBE/WBE Contractor
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Michael Schmidt
ro r atip Item TyRe-
�] Contract
El Amendment
El Bid Award
El Quote Award
C/O & PCA No.
Traffic Control
wired for All Submissions
Proposal � ...�.��w..�,m
® Req. to Advertise
uired Information
1:1,1 PCA
Resolution
H Claim
Addendum
❑ Title Sheet
L Yes U If Yes, Approved by Purchasing
N o
MBE Completed E-Verify Form Attached ❑ Yes
E] WBE ❑ No
Spec T — One (1) Or More 2019 or Newer 4x4 Crew Cab
Concrete Trucks
Sewer Department
50-0621-792.43-02
Opening Bid Date: September 10, 2019
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For Chn Orders rly mmmmm
Amount
�..... Decrease increase $ .........._ �� .....
mount of '�
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Previous Amount $
Current Percent of Change
New Amount
Total Percent of Change:
Time Extension:
Dispersal After Approval
Copy
Original
®
❑ Jeff Hudak
®
❑ Terri Swift
El