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Date February 13, 2020 <br />Department <br />Name Matt Chlebowski Central Services <br />1 11W Mitc.�.......� Fcbrnar 5 , (1 I1 � Phone Extension ��....._._.....___ .___ <br />574-235-9316 <br />aroval Required Prior to Submittal t Board <br />' o <br />...... � ... ....._ .... ._ Review and.Approval l • , q <br />Diversity Compliance ® Officer Name Aladean DeRosewwww —a �✓ <br />and Inclusion Officer <br />BPW Attorney Attorney Name IT Clara McDaniels <br />Dept. Attorney El Attorney Name <br />Purchasing E <br />Michael Schmidt <br />Check the Appropriate Item I y e y� <br />❑ <br />Professional Services Agreement <br />❑Contract <br />EJ <br />Open Market Contract <br />❑ <br />Amendment/Addendum <br />n Bid Opening <br />Bid Award <br />E] Quote Opening <br />E <br />Quote Award <br />n Proposal Opening <br />[:]'C/O <br />& PCA No. <br />❑ <br />Chg. Order, No. <br />[:]' Traffic Control <br />Other: <br />Company or Vendor Name <br />New Vendor <br />MBEAVBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of L---i <br />E <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Information <br />c,Lcar All Submissions <br />Proposal <br />EJ Special Purchase, QPA <br />® Req. to Advertise ❑ Title Sheet <br />❑ Reject Bids/Quotes <br />❑ PCA <br />[� Resolution <br />Ease./Encroach <br />U Yes U If Yes, Approved by Purchasing <br />Fj No <br />❑ MBE Completed E-Verify Form Attached El Yes <br />❑ WBE F] No <br />Spec B — Six Thousand (6.000) More or Less Universal-Nestable Refuse <br />Containers <br />Waste Operations Account 2020 Solid....................�......... <br />610-0610-791-22-24 <br />For <br />Increase $ <br />Decrease All <br />Increase <br />Decrease <br />Orders <br />Increase % <br />Total Percent of Change: Decrease <br />Time Extension Amount: <br />New Completion Date: <br />