HomeMy WebLinkAboutRequest to Advertise - Two (2) More or Less, 2020 or Newer, Mid-Size Four Door Hybrid Sedan Automobiles - Spec FBOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date October 20, 2020
Name Jeff Hudak
Department Central
Services
BPW Date October 27, 2020 Phone Extension
Review and Approval Required Prior to Submittal to Board Diversity Compliance
and Inclusion Officer Officer Name BPW Attorney Attorney Name
Dept. Attorney Attorney Name
Purchasing
Check the Appropriate Item Type – Required for All Submissions
Professional Services Agreement Contract Proposal
Open Market Contract Amendment/Addendum Special Purchase, QPA
Bid Opening Bid Award Req. to Advertise Title Sheet
Quote Opening Quote Award Reject Bids/Quotes
Proposal Opening C/O & PCA No. PCA
Chg. Order, No. Traffic Control Resolution
Other: Ease./Encroach
Required Information
Company or Vendor Name
New Vendor Yes If Yes, Approved by Purchasing
No
MBE/WBE Contractor MBE
WBE Completed E-Verify Form Attached Yes
No
Project Name
Spec F – Two (2) More or Less 2020 or Newer Mid-Size Four Door
Hybrid Sedan Automobiles
Project Number
Funding Source
Water – Cash
Fire - Lease
Account No.
Water – 622-06-604-620-445000
Fire – 287-09-090-098-445000
Amount Water - $25,000
Fire - $30,000
Terms of Contract Cash/Lease
Purpose/Description _Spec F – Two (2) More or Less 2020 or Newer Mid-Size Four Door Hybrid
Sedan Automobiles
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For Change Orders Only
Amount of
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Previous Amount $
Current Percent of Change:
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BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
New Amount $
Total Percent of Change:
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Time Extension Amount:
New Completion Date: