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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW RE QUEST FORM <br />Data 4/3/2018 <br />Name Adam Parsons Department Central Services <br />BPW Date April 10, 2018 Phone Extension 9302 <br />Required Prior to Submittal to Board <br />Legal Attorney Name Clara McDaniels <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller F-1 and greater than one year in length per, the City Purchasing <br />Policy <br />Purchasing [J <br />❑ Agreement <br />❑Contract <br />Proposal M <br />❑ <br />Professional Services <br />❑Amendment <br />[� <br />Bid Opening <br />Bid Award <br />Req. to Advertise Title Sheet <br />E] <br />Quote Opening <br />❑ <br />Quote Award <br />F-1 Chg Order No. <br />F-1 C/O & PCA No. <br />E] PCA <br />F1 Ease./Encroach. <br />F1 Traffic Control <br />EJ Resolution <br />F-1 Other: <br />0 Claim <br />Company or Vendor Name <br />MBEANBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Reauired Information ' <br />0 Yes J_J If Yes, Approved by Purchasing <br />No <br />MBE WBE Completed E-Verify Form Attached El ❑ YeNos <br />CCB qpqates <br />17-017 <br />Various departmental funds <br />TBD-, total estimate of $137,000, with a 5% allowance__ <br />Contract details to be negotiated after RFP selection process <br />Update various CCB offices to better suit current emloloy!g�rofiile <br />For Change Orders Only <br />Amount of El increase $ <br />R Decrease $ APPROVED <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />Time Extension: <br />Dispersal After Approval <br />Original <br />❑ <br />El <br />El <br />Mary Brazinsky, Department of Community <br />Randy Wilkerson, Department of Code Enforcmer/ <br />Shay Davis, Mayor's Office <br />Jen Hockenhull, Department of Administration and Finance <br />