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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date November 16, 2018 <br />Meyer Department DCI <br />Name Pam �........................,. -......................................--...�................................. <br />BPW Date November 27, 2018 Phone Extension 5845��� <br />�rmv�uuummumuuuuuummuiwwuwiuiuimmuuvsmm ., �nm . ��� �i�uuimimuai - � M�mwmmumyw auru000m�oM�omomommmmmmi�mu��a mimmmmmmrm�iuwiummnmmm... <br />Required Prior to Submittal to Board <br />.... ..... .........W ........w <br />Legal Attorney Name Sandra Kennedy <br />Controller M Controller review is required for all Contracts $5,000.00 or more anc <br />greater than one year in length per the City Purchasing Policy <br />Purchasing] <br />.�.,.,.. Check._. <br />the <br />M Agreement <br />❑ Professional Services <br />❑ Bid Opening <br />El Quote Opening <br />[' Change Order No. <br />❑ Ease/Encroach. <br />Other: <br />)ro nate Item T — Re i <br />El Contract <br />El Resolution <br />El Bid Award <br />Quote Award <br />C/O & PCA No. <br />Traffic Control <br />for All Submissions <br />Proposal (Addendum <br />❑ Req. to Advertise ❑ Title Sheet <br />Riegyired Information <br />❑ PCA <br />Company or Vendor Name Rescue Incorporated D/B/A Hope Ministries ._..... <br />New Vendor <br />Yes Z No [:] If Yes, Approved by Purchasing <br />MBE/WBE Contractor <br />MBE [-1 WBE <br />Project Name <br />2018/19 Weather Amnesty Support <br />Project Number <br />1 <br />$22,391 from EDIT 408 (16J013) <br />P.. ... <br />Funding Source <br />...�.....,..,. ��A...... <br />_$36,000 from Gift 227.120.415.39.89 <br />Account No. <br />$69,000 from mm.. �a ..... �� .. _....w. <br />EDIT� <br />408 16JV03 <br />Amount$ <br />....................................... �._.................................. ��... _�...................... <br />127,391.00 <br />Terms of Contract <br />11/14/19-June 302019 <br />Purpose/Description <br />_ <br />Support for various costs related to weather amnesty services <br />El Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E Vermfym,_Iran, etc. _____ . <br />P e aired For Change Orders ON <br />Amount of <br />increase $ <br />Decrease $ <br />Previous Amount <br />$ <br />