Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date . 8/28/19....._._m�. .�. �._........ <br />Department Public <br />Name Scott Kreeger Works <br />BPW Date 9/10/19 <br />ruamea <br />Phone Extension 9245 <br />ummmr�mairmnnn �umwmrcmmumwamwo unu�m <br />�...... ...w.,.-.,.,,,, <br />�.�... <br />__........ w._ <br />.�t�ir�Prior to Submittal to Board ._ <br />BPW Attorney ❑ <br />Attorney Name <br />Clara McDaniels <br />Dept. Attorney [� <br />Attorney Name <br />Purchasing ❑ <br />_�..... .. ......_.w.�.� �,,, � �.........._ �..� n <br />�._.�.. Check the A <br />r( t�iate Item I pe �c mm b All Submissions <br />Professional Services Agreement <br />F Contract <br />Proposal <br />❑ Open Market Contract <br />❑ Amendment/Addendum ❑ Special Purchase, QPA <br />❑ Bid Opening <br />❑ Bid Award <br />❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening <br />❑ Quote Award <br />Reject Bids/Quotes <br />❑ Proposal Opening <br />❑ C/O & PCA No, <br />PCA <br />❑ Chg. Order, No. <br />® Traffic Control: <br />❑ Resolution <br />Residential liandt La p <br />........................ <br />Pam <br />e 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 />Ease./Encroach <br />quired Information <br />LJ YesL] If Yes, Approved by Purchasing <br />❑ No <br />MBE [� WBE Completed E-Verify Form Attached Nos <br />�621 E mIrvm gton Ave Residential Handicap Parking <br />Recommend AITroval <br />�_Foar Chan e Orders OWY � ....__._..... �� ..._.� <br />[� Increase $ <br />Amount of � Decrease ($ _ �... _m...���..... ..m..w <br />....... ........._ .......� .... m�_.......... <br />Previous Amount $ <br />Increase % <br />Current Percent of Change: Decrease m(m_. % <br />New Amount $ <br />Increase % <br />.._......... <br />Total Percent of Change: Decrease %) <br />Time Extension Amount: <br />New Completion Date <br />