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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 02/06/2017 <br />Name Kieran Fahey Department Engineering <br />BPW Date 02/14/2017 Phone Extension 5993 <br />Legal <br />Controller ❑ <br />Purchasing ❑ <br />N _ �hej�ic jhe. <br />❑ Agreement) <br />❑ Professional Services <br />❑ Bid Opening <br />❑ Quote Opening <br />❑ Change Order No. <br />❑ Ease/Encroach. <br />® Other: Board approval <br />for an updated version of <br />the basement valve <br />program (BVP). See <br />Company or Vendor Name: N/A <br />Attorney Name Michael Schmidt <br />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 />H Contract <br />❑ Resolution <br />❑ Bid Award <br />❑ Quote Award <br />❑ C/O & PCA No. <br />❑ Traffic Control <br />Proposal <br />❑ Req. to Advertise <br />Addendum <br />❑ Title Sheet <br />New Vendor <br />❑ Yes ❑ No ❑ If Yes, Approved by Purchasing <br />MBE/WBE Contractor <br />❑ MBE ❑ WBE <br />MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company <br />Project Name <br />Basement Valve Program <br />Project Number <br />000-008 <br />Funding Source <br />_ '"'--`-water <br />Account No. <br />641-0630-793-63-37 <br />Amount <br />Terms of Contract <br />Purpose/Description <br />To have the Board approve minor changes to the basement valve <br />program's eligibility criteria. <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion. Non -Discrimination. Non -Debarment, E-Verifv. Iran, etc.) <br />Amount of H Increase $ <br />❑ Decrease $ <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Ct <br />Copy <br />Original <br />❑ <br />❑ <br />❑ <br />❑ <br />