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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 09106/2018 <br />Name Patrick Sherman <br />Department Venues Parks & Arts <br />BP W Date 09/11/2018 Phone Extension 5601 <br />_Ike quired, Prior to Submittal to Board <br />Legal Attorney Name Clara McDaniels <br />Controller Controller review is required for all Contracts $5,000.00 or imore and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing Michael Schmidt <br />F, Check the Appropriate Item Type — Required for All Submiss,ions <br />F-1 Agreement El Contract El Proposal El Addendum <br />F-1 Professional Services ❑ Resolution <br />F-1 Bid Opening E] Bid Award ❑ Req. to Advertise El Title Sheet <br />F-1 Quote Opening E Quote Award <br />F-1 Change Order No. F-1 C/O & PCA No. RCA <br />[J Ease/Encroach. F-1 Traffic Control <br />n Other: <br />Company or Vendor Name Burkhart Sign Systems <br />New Vendor El Yes M No E:1 If Yes, Approved by Purchasing <br />MBE/WBE Contractor E] MBE [:] WBE <br />MBENVBE Contractor Requested El No El Yes Name of Company <br />Project Name Charles Black Monument Sign <br />Project Number 1072-2018 <br />Funding Source 20,15 Park Bond <br />Account No. 751-1101-452-39.89 <br />FAT" <br />Terms of Contract <br />Purpose/Description <br />Amount of F1 <br />El <br />45 Days <br />New Monument sign with EMC for Charles Black Center <br />Mi, Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verifv, Iran, etc. <br />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 <br />Original <br />❑ <br />F] <br />El <br />F] <br />El <br />D <br />