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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />February 2, 2018 <br />Tara Weigand <br />Department <br />Division/Bureau <br />Public Works <br />Engineering <br />BPW Date February 13, 2018 Phone Extension 5998 <br />Legal Z Attorney Name: Clara McDaniels <br />Controller El Controller review is required for all Contracts $5,0010.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing Michael Schmidt <br />H Agreement Amendment <br />EJ Professional Services <br />[:1 Bid Opening <br />F-1 Quote Opening <br />F Change Order No, <br />F-1 Ease/Encroach. <br />F Other: <br />Company or Vendor Name <br />R Contract <br />F] Resolution <br />F] Bid Award <br />Quote Award <br />iffsT#"Te =.9 <br />New Vendor <br />MBENVBE Contractor <br />MBE/WBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of H Increase <br />El Decrease <br />Pemberton Davis El( <br />R Yes M No <br />Purchasing <br />Proposal <br />❑ Req. to Advertise <br />E] PCA <br />Inc. <br />Addendum <br />n Title Sheet <br />If Yes, Approved by <br />[I MBE F1 WBE <br />F1 No 0 Yes Name of Company <br />FUR Traffic Camera Replacements <br />118-006 <br />LRSA — Traffic Signal Maintenance <br />251-0608-431,36-67 <br />$ 110,110.10 <br />100 days from NTP <br />Replace cameras at Cleveland & Ralph Jones, Cleveland & <br />Bendix, and Portage & Appaloosa intersections. <br />[:1 Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination„ Non -Debarment, E-Verify, Iran, etc.) <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy Original <br />H 0 Roger Nawrot,, Assistant City Engineer <br />M F-1 Derick Roberts, Director of Streets & Sewers <br />M F-1 Ed Gleckler, Manager Bureau of Traffic & Lighting <br />