Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 5/1/2018 <br />Name Brian Donoghue <br />Department Innovation & <br />Technology <br />_13 PW Date 5/8/2 017 Phone Extension 6203 <br />Required Prior to Submittal to Board <br />Legal Z Attorney Name Mills Colborn <br />Controller z Controller review is required for all Contracts $6,000.00 or more and <br />greater than, one year in length per the City Purchasing Policy <br />a lg fil FAII, <br />Z Agreement El Contract F] Proposal Addendum <br />0 Professional Services F-1 Resolution <br />F-1 Bid Opening El Bid Award F-1 Req. to Advertise [] Title Sheet <br />F Quote Opening F-1 Quote Award <br />F-1 Change Order No. ❑ C/O & PCA No. ❑ PCA <br />E] Ease/Encroach. Traffic Control <br />R Other: <br />Company or Vendor Name University of Notr <br />New Vendor F1 Yes M No [ <br />MBEMBE Contractor F-1 MBE n WBE <br />MBEANBE Contractor Requested 0 No F-1 Yes <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 />Name of Company <br />No Cost <br />No Cost <br />518/2018 — 518/2019 <br />Data Sharing Agreement <br />Z Required Contractor's Certification: Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Increase <br />F-1 <br />Amount of E] Decrease <br />Previous Amount $ <br />Current Percent of Change: <br />New Amount <br />'Total Percent of Change: <br />Dispersal After Approval <br />Copy <br />Original <br />F-1 Brian Donoghue <br />Danielle Fulmer <br />F-1 Jitin Kain <br />