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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 9/7/16 <br />BPW Date 9/27/16 <br />Department <br />Fire <br />Phone 9255 <br />Name Todd Skwarcan, A/C Chief/Services <br />o Legal ® Attorney Name Michael Schmidt <br />a� o m Controller review is required for all Contracts $5,000.00 or more <br />o Controller Eland greater than one year in length per the City Purchasing <br />o Policy <br />(ifco Purchasing ❑ <br />Check the Appropriate Item Tvpe — Reauired for All Submissions <br />❑ <br />Agreement <br />I ❑ <br />Contract <br />❑Proposal ❑ Addendum <br />❑ <br />Claim <br />❑ <br />Bid Opening <br />❑ Bid Award I <br />❑ Req. to Advertise <br />I ❑ Title Sheet <br />❑ <br />Quote Opening <br />❑ Quote Award <br />❑ <br />Chg Order No. <br />❑ C/O & PCA No. <br />❑PCA <br />❑ <br />Ease./Encroach. <br />❑ Traffic Control <br />Resolution <br />❑ <br />Other: <br />Required Information <br />Company or Vendor Name <br />Lexipol <br />New Vendor <br />[—]Yes ® <br />No ❑ If Yes, Approved by Purchasing <br />MBEM/BE Contractor <br />❑ MBE ❑ <br />WBE <br />Project Name <br />Project Number <br />Funding Source <br />Other Professional Services <br />Account No. <br />101.0901.422.31-06 <br />Amount <br />$ 9750.00 <br />Terms of Contract <br />Annual <br />Purpose/Description <br />Annual subscription that provides SBFD operating policy & <br />procedure manuals and updates.and daily training bulletins. <br />(Budget transfer required) <br />For Change Orders Only <br />Amount of <br />❑ <br />❑ <br />Increase <br />Decrease <br />$ <br />1 $ <br />Previous Amount <br />$ <br />Current Percent of Change: <br />% <br />New Amount <br />$ <br />Total Percent of Change: <br />% <br />PO No. <br />Copy <br />Original <br />❑ <br />❑ <br />El <br />E <br />Dispersal After Approval <br />Cox <br />