Laserfiche WebLink
BOARD OF PUBIAC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 4127/18 <br />Michelle Smith <br />Department Utilities/Water & WVVTP <br />BPW Date 5/8/18 Phone Extension 5994 <br />- — - ----------- . . .... <br />Required Prior to Submittal to Board <br />Legal X 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 Ilength per the City Purchasing Policy <br />Purchasing F-1 <br />uneCK ine /-\ppropriaie aern i ype — Koguirou Torlin ouorrussio"s <br />Z Agreement El Contract F] Proposal <br />❑ Addendum <br />Professional Services <br />F] Amendment <br />❑ Bid Opening <br />F-1 Bid Award F-1 Req. to Advertise <br />F] Title Sheet <br />❑ Quote Opening <br />El Quote Award <br />❑ Chg Order No. <br />❑ C/O & PCA No. F-1 PCA <br />E] Ease./Encroach. <br />❑ Traffic Control El Resolution <br />El Other <br />0 Claim <br />L_ <br />Required Information <br />Company or Vendor Name <br />Perkin Elmer <br />New Vendor <br />El Yes [:1 If Yes, Approved by Purchasing <br />Z No <br />MBE/BE Contractor <br />Completed E-Verify Form Attached <br />El WBE <br />[J❑ <br />❑Nos <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of <br />Water Works Operating Fund & Wastewater O&M <br />620,0640,603.31.35 5230) & 641.0630.793.63.35J$21 <br />-qa <br />$7410 <br />6 Months, 5/10/18 — 11/9/18 <br />Manufacturer Service Agreement <br />[I I ncrease $ <br />F1 Decrease $ <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Time Extension: <br />0 <br />im <br />Copy Original <br />z F1 Roxanne Lawson <br />z ❑ Emily Leyes <br />1:1 1:1 <br />