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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 10-31-2018 <br />Name Brent Hussung Department Utilities <br />BPW Date 11-13-2018 <br />Phone Extension 5512 <br />mw Wma MIMPMPmIuuWIM <br />---------- <br />Required Prior to Submittal to Board <br />. _.._ _.. _. ..._ .........- � _.......... w_.M <br />Legal 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 />Purchasing Fj <br />Check..the <br />...p <br />N Agreement <br />Professional Services <br />❑, Bid Opening <br />❑ Quote Opening <br />❑ Chg Order No. <br />El Ease./Encroach. <br />Other: <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />)ropriate Item Type <br />El Contract <br />❑ Amendment <br />El Bid Award <br />El Quote Award <br />ElC/O &PCANo, <br />R Traffic Control <br />ui <br />USm,§ignal <br />Yes <br />No <br />❑ MBE <br />❑ WBE <br />for All Submissions <br />Proposal <br />.....�....._......�.�,.,Addendum <br />Req. to Advertise ❑ Title Sheet <br />PCA <br />❑ Resolution <br />F-1 Claim <br />rmation <br />If Yes, Approved by Purchasing <br />Completed E-Verify Form Attached ❑ Yes <br />❑ No <br />O&M <br />620.064 04 <br />$2,520.00 monthlyrecurring $30, . 00 annua ly <br />36 months _ <br />Renewal mofinexistina connectivitv services to provide <br />communications between remote water production sites and the <br />SCADA environment for real-time control and monitoring of water <br />For..�e Orders Onl <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 />❑ <br />El <br />El <br />n <br />❑ <br />