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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FOR.M <br />HPAM <br />Lory Timmer <br />Department DC1 <br />BPW Date 6/12/18 Phone Extension 5841 <br />. . .. . ....... <br />Legal Attorney Name Clara McDaniels <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 />0 a -a I W <br />Agreement <br />F-1 Professional Services <br />[] Bid Opening <br />E] Quote Opening <br />F-1 Change Order No. <br />❑ Ease/Encroach. <br />❑ Other: Amendment <br />Contract <br />El Req. to Advertise <br />Addendum <br />F-1 Title Sheet <br />Company or Vendor Name Department of Community Investment <br />New Vendor El Yes 0 No El If Yes, Approved by Purchasing <br />MBENVBE Contractor F-1 MBE F] WBE <br />MBEMBE Contractor Requested Z No n Yes Name of Company <br />Project Name Activity Delivery / Housing Cq_ynseling Program <br />Project Number 18-JC-98 . . ..... <br />Funding Source Community Development Block Grant DBG) <br />Account No. 212.1001.460.39.30 <br />Amount $80,087 <br />Terms of Contract 1/01/18 — 12/31/18 <br />Purpose/Description Reimburse departme f'6-o—stsfor providing ins ecti-on,—pro-ce-'s-s—in--"-q-",- <br />and housing counseling activities related to CDRG programs <br />M Required Contractor's Certification Form, Attached (Non - <br />Collusion, Non -Discrimination, Non-Debarmenit, E-Verify, Iran, etc. <br />Amount of [I increase --------- <br />F-1 Decrease $ <br />Previous Amount <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy Original <br />M E] Judy Love <br />El El <br />El El <br />