Laserfiche WebLink
(4/14/2011) Jennifer Corle - Agenda Request Form- DSG.doc <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date April 14, 2011 Department Engineering <br />BPW Date April 25, 2011 Phone 235 -5933 <br />Name John Engstrom <br />Requir Legal ❑ Attorney Name <br />ed Controller ❑ Controller review is required for all Contracts $5,000.00 or more <br />Prior and greater than one year in length per the City Purchasing <br />to Policy <br />Submi Other Appropriate Reviewers I i <br />ttal to <br />Board <br />ChPCk the Annrnnriatp Ifpm Tvna _ Rnrndmrl fnr All <br />U Agreement <br />U Contract <br />❑ Pro osal F Addendum <br />❑ Claim <br />Project Name <br />Training Center Site Development Phase 1 <br />G Bid Opening <br />❑ Bid Award ❑ Reg. to Advertise Ti Title Sheet <br />n Quote Opening <br />❑ Quote Award <br />Account No. <br />U Chg Order No. <br />n C/O & PCA No. <br />U PCA <br />Ease. /Encroach. <br />❑ Traffic Control <br />0 Resolution <br />C Other: <br />Training Center Phase 1 Construction <br />Fk(=ie 1111 Cao n <br />Company or Vendor Name <br />I Development Strategies Group <br />New Vendor <br />u Yes ❑ No E If Yes, Approved by Purchasing <br />Project Name <br />Training Center Site Development Phase 1 <br />Project Number <br />109 -011 B <br />Funding Source <br />EMS Capital Fund <br />Account No. <br />E.M.S.C.I.P. #288000 - 341 -03 -00 <br />Amount 1$81,000 <br />PO No. <br />Terms of Contract <br />Purpose /Description <br />Engineering services to prepare plans and specifications for the <br />Training Center Phase 1 Construction <br />For ChaneP Orders nniv <br />Amount of <br />C <br />t� <br />I Increase <br />Decrease <br />$ <br />$ <br />Previous Amount <br />$ <br />Current Percent of <br />Change: <br />% <br />New Amount <br />$ <br />Total Percent of Change: <br />% <br />PO No. <br />ulspersai Aner Approval <br />Copy Original <br />n n <br />L u <br />Page -1 <br />