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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />9/12/1,8 <br />Lory Timmer <br />Department DCl <br />BPW Date 9/25/18 Phone Extension 5841 <br />...... . .... . . . ..... <br />Legal Z Attorney Name Clara McDaniels <br />Controller z Controller review is required for all Contracts $5,0:00.00 or more and <br />greater than one year in length pier the City Purchasing Policy <br />Purchasing z <br />ChecCc the ro date Item Type — Required for All Submissions <br />F-1 Agreement Z Contract [:] Proposal El Addendum <br />F-1 Professional Services <br />[:] Bid Opening <br />F-1 Quote Opening <br />❑ Change Order No. <br />❑ Ease/Encroach. <br />F-1 Other: Amendment <br />El Resolution <br />F-1 Bid Award <br />❑ Quote Award <br />El C/O & PCA No. <br />0 Traffic Control <br />F-1 Req. to Advertise <br />[:] Title Sheet <br />Company or Vendor Name <br />Neighborhood Resources & Technical Services Corporation <br />New Vendor <br />[:1 Yes Z No El if Yes, Approved by Purchasing <br />MBE/WBE Contractor <br />F-1 MBE F-1 WBE <br />MBE/WBE Contractor Requested <br />Z No ❑ Yes Name of Company <br />Project Name <br />Neighborhood Capacity Building Activity <br />Project Number <br />18-JC-86 <br />Funding Source <br />Community Development Block Grant (CDBG) <br />Account No. <br />212.1001.460.3930 <br />Amount <br />$15,000 <br />Terms of Contract <br />1 /01 /18 — 12/31/19 <br />Purpose/Description <br />Help strengthen neighborhood organizations and associations in <br />low -mod income neighborhoods <br />Z Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Nan -Debarment, E-Verify, Iran, etc.) <br />Required For Change Orders Only <br />Amount of El increase $ <br />n 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 />z Judy Love <br />El F-1 <br />El El <br />