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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW RE, QUEST FORM <br />Date June 15, 2018 <br />Department DCI <br />Name Andrew Netter <br />Division/Bureau Planning <br />BPW Date June 26, 2018 <br />Phone Extension 5931 <br />F_ Required Prior to Submittal to Board <br />Legal Z <br />Attorney Name: Clara McDaniels <br />Controller El <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 11 <br />L Check the Appropriate <br />Item Type - Required forAll Submissions <br />El Agreement Amendment <br />El Contract F1 Proposal El Addendum <br />F-1 Professional Services <br />El Resolution <br />n Bid Opening <br />E] Bid Award Z Req. to Advertise ❑ Title Sheet <br />F] Quote Opening <br />n Quote Award <br />[:1 Change Order No. <br />F-1 C/o & PCA No. ❑ PCA <br />F] Ease/Encroach. <br />El Traffic Control: <br />- <br />El Other. <br />Required Information <br />Company or Vendor Name <br />El Yes n No ❑ If Yes, Approved by <br />New Vendor <br />Purchasing <br />MBE/WBE Contractor <br />[:] MBE [:] WBE <br />MBEANBE Contractor Requested [:] No [:] Yes Name of Company <br />Project Name <br />Sale of City -owned Property - 306 Dubail <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />to advertise the sale of 306 Dubail. <br />-Request <br />n Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Required For Chaflg._Orclers.. O-nly <br />Amount of F-1 increase $ <br />❑ Decrease $ . . ........ <br />Previous Amount <br />arkS <br />Current Percent of Change: <br />% -film, 79 W1 fio <br />New Amount <br />VW11 - <br />$ <br />Total Percent of Chanqe: <br />% <br />Dispersal After Approval <br />Copy Original <br />z E] Andrew <br />Netter <br />El ❑ <br />