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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 04/05/2,018 <br />Name Patrick Sherman <br />Department VPA: Facilities & <br />Grounds <br />BPW Date 04/1012018 Phone (Extension 5601 <br />..... . .... . <br />Required Prior to Submittal to Board <br />Legal ❑ Attorney Name Clara McDaniels <br />Controller Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing Michael Schmidt <br />F1 Agreement <br />D14 Contract Proposal <br />Ll Addendum <br />F1 Professional Services <br />El Resolution <br />E] <br />Bid Opening <br />F1 Bid Award [J Req. to Advertise ❑ Title Sheet <br />E] <br />Quote Opening <br />F1 Quote Award <br />F1 <br />Change Order No. <br />F-1 C/O & PCA No. F-1 PCA <br />❑ Ease/Encroach. <br />F-1 Traffic Control <br />Other: <br />Company or Vendor Name D.A. Dodd <br />New Vendor El Yes E No El If Yes, Approved by Purchasing <br />MBEANBE Contractor R MBE R WBE <br />MBE/BE Contractor Requested R No R Yes Name of Company_ <br />Project Name Plumbing Services Contract <br />Project Number 1041-20118 <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />K61 RMT <br />201-1101-452 36.01 <br />Depending on need. Standard irate at $,84.50/hr <br />1 Year with, option to renew for 1 vear <br />Purpose/Description Plumbing services contract for VPA <br />E Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Noin-Debarment, E-Verifv, Iran, etc. <br />Amount of El increase $ <br />El Decrease $ <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Copy <br />Original <br />El <br />n <br />F1 <br />n <br />El <br />El <br />Dispersal After Approval <br />