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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />03/10/2020 m <br />Gerlach <br />Department IT <br />BPW Date 03/24/2020 Phone Extension 6209 <br />MIMIMmmmmmmIMMMmmwmuw�M.� a �ermr v�:n. . , �un�mm�nmm�omm�rmomwmmo ummmnreirrrcattm� .... r rr a... �nugm it ...-A <br />.._.. _ .......... _.._ . Lf� oval Ruu ._.._.. <br />Review and A r�i�~d Prior to Submittal to Board <br />Diversity Compliance <br />and Inclusion Officer Officer Name <br />BPW Attorney ; Attorney Name Clara McBaniels <br />Dept. Attorney Attorney Name Sandra Kennedy <br />Purchasing ® Michael Schmidt <br />Check the Appropriate Item Type <br />Ll Professional Services Agreement ❑ Contract <br />❑ Open Market Contract <br />❑ Amendment/Addendum <br />❑ Bid Opening <br />❑ Bid Award <br />Quote Opening <br />[:] Quote Award <br />Proposal Opening <br />F-1 C/O & PCA No. <br />Chg. Order, No. <br />F] Traffic Control <br />El Other: Lease Schedule <br />euire In ormation <br />All Submissions <br />Proposal <br />L Special Purchase, QPA <br />❑] Req. to Advertise <br />Reject Bids/Quotes <br />PCA <br />❑ Resolution <br />Ease./Encroach <br />❑ Title Sheet <br />Company or Vendor Name Dell <br />m®...Nos._..YeE]If Yes, A roved... b.................r m............................................... <br />New Vendor Pp y Purchasing <br />MBE/WBE Contractor ❑❑ WBE Completed E-Verify Form Attached ❑' Nos <br />Project Name TouhBook L,aJteJs for Water Works and Waste Water <br />��. . � ... <br />Project Number N/A <br />Funding Source I.... �, _....m.. ..._..........w. <br />T Lease <br />.. <br />Account No. Prm.279-0672-4.................... �..........__ _...... <br />........... <br />15-38.01Int.279-0�6.7�2._.4.1.�5._.3.........__�........................................................... <br />8.02 <br />Time Extension Amount: <br />New Completion Date: <br />