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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />08/23/2018 <br />Patrick Sherman <br />Department Venues Park & Arts <br />BPW Date 08/24/2018 Phone Extension. 5,601 <br />Reg uired, Prior to Submittal 1cr Poard <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 Z Michael Schmidt <br />❑I Bid Opening <br />[] Quote Opening <br />❑ Change Order No. <br />❑ Ease/Encroach. <br />Other: <br />❑ Req. to Advertise <br />XM <br />❑ Title Sheet <br />Company or Vendor Name <br />Carpet Service Outlet Inc <br />New Vendor <br />El Yes Z No EJ If Yes, Approved by Purchasing <br />MBENVBE Contractor <br />❑ MBE [:] WBE <br />MBENVBE Contractor Requested <br />❑ No ❑ Yes Name, of Company <br />Project Name <br />Century Center Recital Hall Carpet <br />Project Number <br />1070-201 8 <br />Funding Source <br />Hotel/ Motel Tax Fund <br />Account No. <br />N/A <br />Amount <br />$15,886.00 <br />Terms of Contract <br />Lump Sum <br />Purpose/Description <br />New Carpet.in recital hall within the Century Center. <br />Z Requiired Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Required, For'Ghange Orders ,Only <br />Amount of F] increase $ <br />❑ Decrease $ <br />Previous Amount <br />$ <br />Current Percent of Change: <br />% <br />New Amount <br />$ <br />Total Percent of Change: <br />% <br />Dispersal After Approval <br />Copy Original <br />F-1 <br />