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BOARD OF PUBLIC WORK'S <br />AGENDA ITEM REVIEW REQUEST FORM <br />8/30/18 <br />Lorv'Timmer <br />Department DC] <br />BPW Date Phone Extension 5841 <br />... . . . .... . ...... - ............. . ..... . ...... <br />Legal Z Attorney Name Clara McDaniels <br />Controller z 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 <br />H Agreement <br />N Contract LJ Proposal L] Addendum <br />F-1 Professional Services <br />0 Resolution <br />❑ Bid Opening <br />F-1 Bid Award El Req. to Advertise E] Title Sheet <br />F-1 Quote Opening, <br />F-1 Quote Award <br />F-1 Change Order No. <br />F-1 C/O & PCA No. Fj PCA <br />[:] Ease/Encroach. <br />F-1 Traffic Control <br />F-1 Other: Amendment <br />Company or Vendor Name The Center for the Homeless, Inc. <br />New Vendor El Yes Z No [:1 If Yes, Approved by Purchasing <br />MBE/WBE Contractor F-1 MBE F-1 WBE <br />MBE/WBE Contractor Requested Z No Yes, Name of Company <br />Project Name Emergency Shelter Operations <br />Project Number 18-JE-33 <br />Funding Source Emergency Solutions Grant (ESG) <br />Account No. 212.1001.460.39.30 <br />Amount $31,000, <br />Terms of Contract 1 /01 /18 — 12/31/18 <br />Purpose/Description Subsidize costs associated with operating an emergency shelter for <br />homeless individuals <br />Z Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc. <br />Amount of F-1 increase <br />F1 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 />F1 F-1 Judy Love <br />F-1 El <br />El 11 <br />