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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date September 17,2018 <br />Name Pam Meyer Department <br />DCI <br />_BPW Date September 25, 2018 Phone Extension 5845 <br />Required Prior to Submittal to Board <br />Legal Z Attorney Name Clara McDaniels Sandra Kennedy <br />Controller ❑ Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing [:1 <br />X Agreement <br />F-1 Professional Services <br />E] Bid Opening <br />E] Quote Opening <br />F] Change Order No. <br />F-1 Ease/Encroach. <br />F-1 Other: <br />Company or Vendor Name <br />H Contract <br />F-1 Resolution <br />Bid Award <br />❑ Quote Award <br />El C/O & PCA No. <br />F-1 Traffic Control <br />Center for the Homeless <br />[] Req. to Advertise R Title Sheet <br />sm <br />New Vendor [:] Yes M No [:1 If Yes, Approved by Purchasing <br />MBE/WBE Contractor E] MBE [] WBE <br />Project Name Permanent Supportive Housing <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />GOIT <br />404,0401 A15.31.06 <br />$ 100,000.00 <br />10/1/18-12/31/19 <br />Purpose/Description Services for development and management of scattred site permanent <br />supportive housing for chronically homeless <br />M Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Amount of ❑ <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 Original <br />Pam Meyer, DC1 <br />