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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />11/21/17 <br />Lory Timmer - Department -DCI <br />BPW Date 12/12/17 Phone Extension 5841 <br />Controller <br />Purchasing <br />H Agreement <br />F-1 Professional Services <br />n Bid Opening <br />F-1 Quote Opening <br />El Change Order No. <br />F-1 Ease/Encroach. <br />F� Other: Amendment <br />Attorney Name Clara McDaniels <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 H Proposal LJ Addendum <br />F-1 Resolution <br />F-1 Bid Award F1 Req. to Advertise El' Title Sheet <br />El Quote Award <br />n C/O & PCA No, El PCA <br />F-1 Traffic Control <br />Company or Vendor Name Near Northwest Neighborhood, Inc. <br />New Vendor M Yes F1 No 0 If Yes, Approved by Purchasing <br />MBENVBE Contractor F-1 MBE E] WBE <br />MBE/VVBE Contractor Requested F] No F] Yes Name of Company <br />Project Name Acquisition- Rehabilitation Program @ 754 Cottage Grove Ave, <br />Project Number 16-JC-23 <br />Funding Source Community Development Block Grant (CDBG) <br />Account No. 212.1001.460.39.30 <br />Amount $184,500 (contract amount remains the same) <br />Terms of Contract 1/01/16- 12/31/18 <br />Purpose/Description Extend contract timeframe by 12 months, through 12/31/18 <br />Z Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc,) <br />qu I/Ro i rooFor C 1100 , '9 6 01'r p, Amount of El increase $ <br />E] Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: <br />Copy <br />Original <br />F-1 <br />J <br />Love <br />