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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 4/3/2018 Department Fire <br />BPW Date 4/10/2018 Phone 9255 <br />.... . ..... <br />Name Todd Skwarcan, A/C Services <br />.. ................. . ..... . . ... . ...... <br />Legal Attorney Name Elliott Anderson <br />4- <br />a) 0 — Controller review is required for all Contracts $5,000.00 or more <br />72 Controller F❑ and greater than one year in length per the City Purchasing <br />Co <br />E M0 <br />W IL -5 Policy <br />W Purchasing <br />Check the Appropriate Item Tvpe - Required for All Submissions <br />Agreement <br />L] Contract 1I Ll Proposal Addendum <br />El <br />Claim <br />_I_Lj <br />­__ <br />El <br />Bid Opening <br />El <br />Bid Award <br />i_e7 <br />❑ Req. to Advertise <br />1-0 <br />D Title Sheet <br />E] <br />Quote Opening <br />El <br />Quote Award <br />E] <br />Chg Order No. <br />❑ <br />C/O & PCA No. <br />❑ <br />PCA <br />El <br />Ease./Encroach. <br />El <br />Traffic Control <br />El <br />Resolution <br />M <br />Other: Special, <br />Purchase <br />Reauired <br />Information <br />Company or Vendor Name <br />Rosenbauer <br />New Vendor <br />El <br />Yes 0 <br />No If Yes, Approved by Purchasing <br />MBE/VVBE Contractor <br />❑ <br />MBE [:] WBE <br />-Project Name <br />-Project Number <br />Funding Source <br />Aerial Apparatus <br />Lease Purchase <br />Account No. <br />Principal 287.0902.422.37-11; interest 287.0902.422.37-12 <br />Amount <br />$ 982,147.00 <br />Terms of Contract <br />Payment due upon delivery <br />Purpose/Description <br />Planned replacement of aerial fleet. Unit is a 1 00�' mid -mount <br />tower aerial apparatus; demo model unit. <br />Amount of <br />❑E <br />increase <br />Decrease <br />Previous Amount <br />Current Percent of Change: <br />$ <br />% <br />New Amount <br />$1 <br />Total Percent of Change, <br />1% <br />PO No. <br />Dispersal After Approval <br />Copy Original <br />F1 F-1 <br />R El <br />