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M <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />3/5/2018 <br />Christine Villaire <br />Department Admin & Finance <br />BPW Date 3/13/2018 Phone Extension 9957 <br />F_ Required Prior to Submiittal to Board <br />Legal Attorney Name Clara McDaniels <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller Z and greater than one year in length per the City Purchasing <br />Policy <br />Michael Schmidt <br />M Agreement <br />H Contract <br />n Proposal El Addendum <br />M Professional Services <br />M <br />Amendment <br />EJ <br />Bid Opening <br />0 <br />Bid Award <br />El Req. to Advertise ❑ Title Sheet <br />El <br />Quote Opening <br />F-1 <br />Quote Award <br />Chgi Order No. <br />El C/O & PCA No. <br />F-1 PCA <br />Ease./Encroach, <br />❑ Traffic Control <br />n Resolution <br />Other: <br />F-1 <br />Claim <br />Company or Vendor Name <br />New Vendor <br />�MBEANBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />If Yes, Approved by Purchasing <br />Completed E-Verify Form Attached El Yes <br />[:] No <br />None <br />IT OperatiM <br />2,79-0672-415-36-04 <br />$10,500 tr. <br />2 ears <br />Applicant tracking system. Extend the agreement for an <br />additional two years. All other terms remain the same. <br />Amount of ❑ Increase <br />Decrease <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Time Extension: <br />Bi- <br />Dispersal After Approval <br />Copy Original <br />F1 Kyra Clark, Christine Villaire, Jen Hockenhull <br />❑ ❑ Dan O'Connor, -Shawn Delahanty <br />El F-1 <br />