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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />7-13-18 <br />Scott Horvath <br />Department Utilities - Water <br />BPW Date July 24th Phone Extension 5665 <br />Require J Prior to Submittal to Board <br />Legal X Attorney Name <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller and greater than one year in length per the City Purchasing <br />Policy <br />I FAR <br />Agreement <br />E] Professional Services <br />El Bid Opening <br />F] Quote Opening <br />F-1 Chg Order No. <br />E]; Ease./Encroach. <br />0 Other: Sole Source <br />LJ Contract <br />El Amendment <br />F] Bid Award <br />F-1 Quote Award <br />C/O & PCA No. <br />Traffic Control <br />E] Req. to Advertise <br />F1 PCA <br />F] Resolution <br />El Claim <br />Addendum <br />F-1 Title Sheet <br />Required Information <br />Company or Vendor Name Midwest Meter <br />New Vendor El Yes If Yes, Approved by Purchasing <br />M No <br />MBEA/VBE Contractor E] MBE Completed E-Verify Form Attached F-1 Yes <br />n WBE El No <br />Project Name Meter reading radio receivers and supporting hardware <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />P,urpose/Description <br />Water W)rks Operating Fund <br />620-0640-605-22-06 <br />$39,864.72 <br />To accommodate the techs to read both style meters <br />Amount of LJ Increase <br />E] Decrease <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Time Extension: <br />Copy <br />Original <br />F-1 <br />Roxanne Lawson <br />Kim Thompson <br />Scott Horvath <br />