HomeMy WebLinkAboutRequest to Advertise - One (1) or More, 2020 or Newer, Emergency Medical Vehicle – Spec P
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
DateSeptember 10, 2020
Department
NameJeff Hudak
BPW DateSeptember 22, 2020Phone Extension
Review and Approval Required Prior to Submittal to Board
Diversity Compliance
Officer Name
and Inclusion Officer
BPWAttorneyAttorney Name
Dept. AttorneyAttorney Name
PurchasingMichael Schmidt
Check the Appropriate Item Type Required for All Submissions
Professional Services AgreementContractProposal
Open Market ContractAmendment/Addendum Special Purchase, QPA
Bid OpeningBid AwardReq. to AdvertiseTitle Sheet
Quote OpeningQuote AwardReject Bids/Quotes
Proposal OpeningC/O & PCA No. PCA
Chg. Order, No. Traffic ControlResolution
Other: Ease./Encroach
Required Information
Company or Vendor Name
YesIf Yes, Approved by Purchasing
New Vendor
No
MBEYes
MBE/WBE ContractorCompleted E-Verify Form Attached
WBE No
Project NameSpec P -One (1) or More 2020 or Newer Emergency Medical Vehicle
Project Number
Funding SourceFire -Lease
Account No.287-09-090-098-445000
Amount$280,000
Terms of ContractLease
Purpose/Description_One (1) or More 2020 or Newer Emergency Medical Vehicle
_______________________________________________________________
_______________________________________________________________
__________________________________________________
For Change Orders Only
$
Increase
Amount of
Decrease($)
Previous Amount$
%
Increase
Decrease(%)
Current Percent of Change:
New Amount$
%
Increase
Decrease(%)
Total Percent of Change:
TimeExtensionAmount:
New Completion Date: