Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />11 /29/18 <br />Liz Maradik <br />Department DCI <br />BPW Date 12/11/18 Phone Extension x5821 <br />w�uwu�i��imiwmuiuiuummr�iRir�.iuiuiuiuiuiuiuiuiuimuw�uwmuuuuuuwwewuuuuiWiuuuiwrrmm . iuiuimuimNumnn r, wrrr��iHiHiHiHiHiHiHiHiHiHiHiHUHUHuuumHUHimimimimiHiHiHiHiHiHiHiH�rtrrt�uuuuuuuuuumHUHUHUHUHUHuuuuuuuuuuuuuHUHUHUHmwuiwuwuuwuiuiuiuiuiuiuiuiu�uy� <br />.._..m_. .._ .. ._.._ .. <br />.. _.. Required_Prior to Submittal to Board �.__.�.._ ..�.�.. _...� <br />Legal Attorney Name Sandi 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 />Purchasing E] <br />Check the A <br />J Agreement <br />Professional Services <br />R Bid Opening <br />E Quote Opening <br />R Chg Order No. <br />E] Ease./Encroach. <br />F-1 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 />iroprlat+e Item "ye <br />Contract <br />7 Amendment <br />for All Submissions <br />Proposal <br />El Bid Award ❑ Req. to Advertise <br />❑ Quote Award <br />0 C/O & PCA No. PCA <br />El Traffic Control El Resolution <br />E <br />..�.................... <br />Claim <br />Required Information <br />Addendum <br />❑ Title Sheet <br />.. Incremental iance <br />Development f Yes,Approved <br />by...Purchasing ..............�.�.�.�......�.�.�.�...m..........�..... <br />® No <br />❑ MBE Completed E-Verify Form Attached 0 Nos <br />E <br />WBE <br />Near Northwest Neighborhood Plan <br />EDIT <br />408-1001-460-31.06 <br />0 <br />For Change Orders Only,_ <br />�.....- ...-�a ...... <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 />El <br />E] <br />1 <br />❑I <br />E, <br />