Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 04/04/2019 <br />Name Patrick Sherman <br />Department VPA <br />BPW Date 04/09/2019 Phone Extension 5601 <br />IWW4WN NWIIIIIIIIIIIIIIIIIIIIIIIWIWwwm NOW i <br />_ _._..._ <br />R �t�,!red Prior to Submittal Board <br />Legal ® Attorney Name Dani Campbell Weiss <br />Controller ® Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing <br />_......�.. Cher <br />H Agreement <br />El Professional Services <br />Bid Opening <br />M Quote Opening <br />❑ Change Order No. _ <br />❑ Ease/Encroach. <br />Other: <br />® Michael Schmidt <br />...._._ _ _.W... ................. <br />the Appropriate Item Type — Required for All Submissions <br />U Contract ❑ Proposal ❑ Addendum <br />Resolution <br />❑ Bid Award ® Req. to Advertise ❑ Title Sheet <br />F-1 Quote Award <br />El C/O & PCA No. ❑ PCA <br />0 Traffic Control <br />Re uired Information <br />Company or Vendor Name TBD <br />New Vendor Yes EJ No ❑ If Yes, Approved by Purchasing <br />MBE/WBE Contractor ❑ MBE ❑ WBE <br />MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company <br />Project Name VPA Sign.ae and Wayfindin m <br />Project Number 1080-2019 <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of <br />❑ <br />Various <br />Various <br />$ TBD —Based ._._ on BPW...................._W.. <br />.. approved contract <br />PerRF.P.................................. ............ <br />Development, fabrication, and installation of sianaae and wavfindina <br />for Howard and other VPA properties, <br />® Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etch <br />Reciuired For Chane Orders OnIIv <br />Increase <br />Decrease $ <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />LJIDPUI JQI /-%I LUI /`%PP1 V VCl1 <br />01 <br />Copy Original <br />El R <br />El ❑El R <br />. �. <br />