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BOARD OF PUBLIC `WOR1,CS <br />AGENDA ITEM REVIEW RE QUEST FORM <br />Date 8/10/18 <br />Name <br />Lary Timmer <br />Department <br />DC1 <br />BPW Date <br />8/28/18 <br />Phone Extension <br />5841 <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 <br />Gheck't ie Ap rwriatedtornType — I PwquimdfiorAff Submissions _J <br />El Agreement M Contract [:] Proposal El Addendum <br />F-1 Professional Services <br />[J Bid Opening <br />E] Quote Opening <br />❑ Change Order No. <br />Ease/Encroach. <br />F-1 Other: Amendment <br />Resolution <br />Bid Award <br />F1 Quote Award <br />El C/O & PCA No. <br />n Traffic Control <br />n Req. to Advertise <br />FEM <br />Company or Vendor Name Near Northwest Neighborhood, Inc.. <br />New Vendor F-1 Yes M No El If Yes, Approved by Purchasing <br />MBENVBE Contractor ❑ MBE F-1 WBE <br />MBENVBE Contractor Requested'o No [J Yes Name of Company <br />Project Name CDBG Activity Delive <br />Project Number 184C-84 <br />Funding Source Community Development Block Grant (CDBG) <br />Account No. 212.1001,460.39.30 <br />Amount $80,000 <br />F1 Title Sheet <br />Terms of Contract 1/01/18 — 12/31/18 <br />Purpose/Description Subsidize staff costs associated with ope j6j6­CDBG-funded <br />housing prograrn <br />M Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verifv, Iran, etc. <br />Amount of El increase <br />[] Decrease <br />Previous Amount $ <br />Current Percent of Change: <br />New Amount $ <br />Total Percent of Change: <br />Dispersal After Approval <br />Copy Original <br />M Judy Love <br />F1 F-1 <br />R E] <br />