HomeMy WebLinkAboutRequest to Advertise - Two (2), More or Less, 2020 or Newer, Trailer Mouted Anti-Icing System - Spec UBOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date November 16, 2020
Name Jeff Hudak
Department Central
Services
BPW Date November 24, 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 U-Two (2) More or Less 2020 or Newer Trailer Mounted Anti-Icing
System
Project Number
Funding Source Streets/Lease
Account No. 202-06-602-503-445000
Amount $100,000
Terms of Contract Lease
Purpose/Description Spec U-Two (2) More or Less 2020 or Newer Trailer Mounted Anti-Icing
System
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For Change Orders Only
Amount of Increase
Decrease
$
($ )
Previous Amount $
Current Percent of Change:
Increase
Decrease
%
( %)
New Amount $
Total Percent of Change:
Increase
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%
( %)