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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date June 1, 2018 <br />Name Tara Weigand <br />Department <br />Division/Bureau <br />Public Works <br />Engineering <br />BPW Date June 12, 2018 Phone Extension 5998 <br />Legal ❑ Attorney Name: <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 />H Agreement Amendment L_] Contract [_J Proposal L] Addendum <br />F1 Professional Services F-1 Resolution <br />❑I Bid Opening n Bid Award ❑ Req. to Advertise El Title Sheet <br />El Quote Opening F-1 Quote Award <br />F-1 Change Order No. El C/O & PCA No. PCA <br />n; Ease/Encroach, N Traffic Control: Residential Handicap Parking <br />F-1 Other: <br />Company or Vendor Name <br />New Vendor <br />MBEIWBE Contractor <br />KBENVIBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of F] increase <br />[] Decrease <br />Previous Amount $ <br />Current Percent of Change: <br />New Amount $ <br />Total Percent of Chanae: <br />El Yes El No ❑ If Yes, Approved by <br />Purchasing <br />[I MBE 0 WBE <br />F-1 No 0 Yes Name of Company <br />433 S Grant Residential Handicap Parkina <br />Recommend Approval <br />0 Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Copy Original <br />M E] Roger Nawrot, Assistant City Engineer <br />M F-1 Ed Gleckler, Manager Bureau of Traffic & Lighting <br />M F1 SBPD <br />