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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 9-17-1.8 .— <br />Name Kim Thompson <br />Department UtilitiesNVater <br />BPW Date 9-18,-18 Phone Extension 5969 <br />---------- ----- --------- - ----- <br />. . ......... <br />Legal Attorney Name Clara McDaniiels <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller E:1 and greater than one year in length per the City Purchasing <br />Policy <br />Purchasing F-1 <br />L Agreement H Contract L] Proposal H Addendum <br />F-1 Professional Services M Amendment <br />F-1 Bid Opening F-1 Bid Award F-1 Req. to Advertise El Title Sheet <br />F-1 Quote Opening ❑ Quote Award <br />[:1 Chg Order No. ❑ C/O & PCA No. F-1 PCA <br />El Ease./Encroach. El Traffic Control F-1 Resolution <br />F1 Other: F] Claim <br />?WNIV-71 =10 I <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 />Arcadis <br />El Yes E] If Yes, Approved by Purchasing <br />0 No <br />DIVIBE Completed E-Verify Form Attached <br />F-1 WBE <br />North Station Well #1 Replacement Amendment #2 <br />16WO01 <br />Water Works Engineering <br />62,0-0640-658-3102 <br />$33.820 <br />Assistance with well replacement and bidding. <br />F� increase $ <br />El Decrease $ <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Time Extension: <br />a <br />Copy Original <br />M F-1 Kim Thompson <br />E E] Roxanne Lawson <br />F El <br />El Yes <br />[:] No <br />