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N <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM RE, VIEW IU:,QUEST FORM <br />June 15, 2018 <br />Andrew Netter <br />Department <br />Division/Bureau <br />79M <br />AMM <br />BPW Date June 26, 2018 Phone Extension 5931 <br />Required Prior to Submittal to Board <br />Legal Attorney Name- Clara McDaniels <br />Controller ❑ Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the, City Purchasing Policy <br />Purchasing F-1 <br />Check the A=roDriate Item TvDe — Reauired for All Submissions <br />Agreement Amendment <br />F-1 Contract <br />❑ Proposal ❑ Addendum <br />❑ Professional Services <br />0 Resolution <br />n Bid Opening <br />F] Bid Award <br />Req. to Advertise El Title Sheet <br />F-1 Quote Opening <br />n Quote Award <br />0 Change Order No. <br />n C/O & PCA No. <br />F-1 PCA <br />El Ease/Encroach. <br />F-1 Traffic Control: <br />❑ Other: <br />Required Information <br />Company or Vendor Name <br />❑ Yes F-1 No <br />El If Yes, Approved by <br />New Vendor <br />Purchasing <br />M' BENVBE Contractor <br />[:] MBE [:] WBE <br />MBE/WBE Contractor Requested n No E] Yes Name of Company <br />Project Name <br />Sale of City -owned Property <br />- 11 2q_Lawrence <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description Request to advertise the sale of 1129 Lawrence. <br />n Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />L Required For Change Orders Only <br />Amount of F-1 increase <br />r-$ <br />Decrease $ of puma reas <br />, Previous Amount d-1 <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Copy <br />Original <br />M <br />F] <br />aka <br />Disioersal After Ar)r)roval <br />Andrew Netter <br />VIM-" <br />