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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 2/28/18 <br />Name Lary Timmer <br />Department -DCI <br />BPW Date 3/13/18 <br />Phone Extension 5841 <br />.... ...... <br />'Roquired, Prior to 8and <br />Legal <br />Attorney Name Clara McDaniels <br />Controller ❑ <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 />Purchasing El <br />Check the, ppprp-� <br />6/,,, Item Type,— <br />, pr quhq#`fioar ,AJ[S'U ls�si&ns- <br />F-1 Agreement <br />❑ Contract R Proposal! El Addendum <br />0 Professional Services <br />F-1 Resolution <br />Ej Bid Opening <br />El Bid Award R Req. to Advertise El Title Sheet <br />F-1 Quote Opening <br />❑ Quote Award <br />0 Change Order No, <br />❑ C/O & PCA No, ❑ PCA <br />F-1 Ease/Encroach. <br />❑ Traffic Control <br />M Other: Amendment <br />Company or Vendor Name Department of Code Enforcement <br />New Vendor <br />El Yes M No 0 If Yes, Approved by Purchasing <br />MBE/WBE Contractor <br />E] MBE E] WBE <br />MBEANBE Contractor <br />Requested M No 0 Yes Name of Company <br />Project Name <br />Vacant & Abandoned Building Demolition Program <br />Project Number <br />16-JC-14 <br />Funding Source <br />----- ----- <br />Community Development Block Grant (CDBP).___._._ <br />Account No. <br />212.1001.460.39,.30 <br />Amount <br />$154,185.00 (increase of $4,185,00) <br />Terms of Contract <br />1 /01 /16 - 12/31/18 <br />Purpose/Description <br />Increase 2016 CDBG demolition contract by $4,185 (remaining <br />balance of expired 2015 CQBG demolition contract) <br />Z Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.l <br />RequIro, For Ghan, Q rd,&r,,,, OhIy <br />Amount of El <br />El <br />increase $ . .......... .... . ......... <br />Decrease $ <br />Previous Amount <br />. ... . . ..... .... . .... ... <br />Current Percent of Change: % <br />New Amount <br />$ <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy Original <br />F] <br />Judy Love <br />❑ El <br />El R <br />