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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date JuIv 26th 2018 <br />Department Innovation and <br />Name Brian Donoghue Technology <br />�BPW Date August 14 1h 2018 Phone Extension <br />Required Prior to Submittal to Board <br />Legal Attorney Name Sandra Kennedy <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller EJ and', greater than, one year in, length per the City Purchasing <br />Policy <br />Purchasing F-1 <br />Check the Appropriate <br />Item Type - Required for All Submissions <br />F-1 <br />Agreement . <br />N Contract El Proposal <br />F-1 Addendum <br />N <br />Professional Services <br />0 Amendment <br />F-1 <br />Bid Opening <br />El Bid Award E] Req. to Advertise <br />E] Title Sheet <br />F-1 <br />Quote Opening <br />El Quote Award <br />F-1 <br />Chg Order No. <br />F-1 C/O & PCA No. F-1 PCA <br />[:] <br />Ease./Encroach. <br />n Traffic Control El Resolution <br />F1 <br />Other: <br />0 Claim <br />Required Information <br />Company or Vendor Name <br />MetroNet Zing <br />F1 Yes El If Yes, Approved by Purchasing <br />New Vendor <br />M No <br />MIBEANBE Contractor <br />EIMBE Completed E-Verify Form Attached <br />0 WBE <br />El Yes <br />No <br />Project Name <br />Digital Access Sites <br />Project Number <br />Funding Source <br />Innovation and Technology Professional Services Account <br />Account No. <br />279-0672-415-31-06 <br />Amount <br />$0.00 <br />Terms of Contract <br />Purpose/Description <br />Providing and installing new conduit and fiber for Charles Black <br />Center- See memo <br />For Change Orders Only <br />Amount of F-1 increase $ <br />n Decrease $ <br />Previous Amount $ <br />Current Percent of Change. % <br />New Amount $ <br />Total Percent of Change: % <br />Time Extension: <br />Dispersal After Approval <br />Copy <br />Original <br />F-1 <br />F-1 <br />F-1 <br />El <br />El <br />El <br />