Laserfiche WebLink
BOARD OF PUBLIC 'WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 8/29/2018 <br />Name Shawn Delahanty Department <br />Innovation & Tech <br />Legal Attorney Name Kennedy <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller ® and greater than one year in length per the City Purchasing <br />Policy <br />r a . 11$ 11,34 <br />nec <br />zc omissions <br />❑ <br />Agreement <br />❑ Contract <br />❑ Proposal ❑ Addendum <br />El <br />Professional Services <br />❑ <br />Amendment <br />❑ <br />Bid Opening <br />❑ <br />Bid Award <br />❑] Req. to Advertise F1 Title Sheet <br />❑ Quote Opening <br />❑ Quote Award <br />❑ Chg Order No. <br />❑ C/O & PCA No. <br />❑ PCA <br />Ease./Encroach. <br />❑ Traffic Control <br />❑ Resolution <br />Other: Hardware Lease <br />I —I <br />Claim <br />Company or Vendor Name <br />Pik M "NAMI <br />MBENVBE Contractor <br />Project Name <br />Project dumber <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />AT&T Mobil <br />❑ Yes <br />F-1 No <br />If Yes, Approved by Purchasing <br />El <br />❑ MBE Completed E-Verlify Form Attached ElNo <br />Mobile Tablet Lease <br />IT Lease Account <br />279-0672-415-37-11 (principal) and 37-12 (interest) <br />$656.22 per month for 36 months ($23,623.92 total) <br />36 months <br />Purpose/IDescription 32 i ads for Streets Sewers VPA Clerk Council Animal <br />Control; Surfaces for VPA and Police <br />For Change Orders Only <br />Amount of ❑ ,. increase $ <br />❑ Decrease $ <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Time Extension: <br />Dispersal After Approval <br />Copy <br />Original <br />® <br />❑ Shawn Delahainty <br />❑ <br />❑ <br />