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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date November 28,2017 <br />Name Pam Meyer Department <br />December 12, 2017 <br />DCl <br />BPW Date Phone Extension 5845 <br />R aired Pio to ��ar�kl°fac�rd <br />Legal Attorney Name Ben Dougherty <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 El <br />M Agreement <br />0 Contract LJ Proposal Addendum <br />F-1 Professional Services <br />EJ Resolution <br />0 Bid Opening <br />El: Bid Award E] Req. to Advertise ❑ Title Sheet <br />F-1 Quote Opening <br />F-1 Quote Award <br />F-1 Change Order No. <br />F C/O & PCA No. E] PCA <br />R Ease/Encroach. <br />F-1 Traffic Control <br />El Other: <br />R ,airedlnf irr ati op <br />Company or Vendor Name <br />Neighborhood Resource Connection <br />New Vendor <br />MBEMBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />E] Yes H No [_1 If Yes, Approved by Purchasing <br />F-1 MBE [:] WBE <br />EDIT <br />408.1001.460.39.30 <br />Amount $ 100,000 <br />Terms of Contract January 1, 2018-Deembci 31, 2018 <br />Purpose/Description Support of programs, training and education for neighborh000d <br />residents, including youth, to encourage resident leadership, <br />communication and involvement <br />Z Required Contractor's Certification Form Attached (Non - <br />Collusion, Non-Discrimi,nation, Non -Debarment, E-Verify, Iran, etc. <br />Amount of <br />Previous Amount <br />F-1 increase $ <br />F-1 Decrease $ <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy Original <br />M Pam Meyer, DC1 <br />F-1 <br />El <br />