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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date December 17, 2018 <br />Name Kara M. µBoyles <br />Department Engineering <br />Division/Bureau DPW <br />BPW Date 12/20/18 Phone Extension 5933 <br />mowrm ommmmmm mom HPUMMMUmmmimiMUM m NNE <br />.... ._.. ........_.. .._........ ..... ...— ....... <br />........ <br />Req Prior to Submittal to Board <br />Legal g ® Attorney Name: C. McDaniels <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 ❑ <br />Check the <br />N Agreement <br />Professional Services <br />❑ Bid Opening <br />E] Quote Opening <br />❑ Change Order No. _ <br />❑ Ease/Encroach. <br />R Other: <br />Company or Vendor Name <br />iTropriate Item_Ti yfae <br />Contract <br />❑ Resolution <br />❑ Bid Award <br />El Quote Award <br />�C/O &PCANo. <br />Traffic Control: <br />New Vendor <br />MBE/WBE Contractor <br />MBE/WBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of LJ Increase <br />Decrease <br />Previous Amount $ <br />Current Percent of Change: _......... <br />New Amount m $ <br />Total Percent of Change: .... <br />Copy <br />Original <br />❑ <br />EJ <br />E <br />❑ <br />❑ <br />Required Information <br />for All Submissions <br />__ .... <br />Proposal <br />Req. to Advertise <br />0 PCA <br />Addendum <br />❑ Title Sheet <br />Professional Services with CBBEL <br />Yes ❑ No If Yes, Approved by <br />Purchasing <br />_w_... <br />MBE LJ WBE <br />-0 No L1 Yes Name of Com n <br />.. <br />Impervious Cover Based Stormwater Utility - Phas_.. <br />el <br />119-110....._ <br />Professional Services <br />101-0602-431.31-06 <br />_................. . _... <br />$35,500 (lump sum contract) <br />6 months ....._. <br />Im envious ................... <br />surf _ .....a. _..... <br />p ace digitization of residential and non-residential city <br />properties for the purpose of establishing an equivalent residential unit <br />for stormwater utility fees. <br />................ .............. _..... .. <br />Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />red For Charade Orders On <br />Dispersal ter Approval <br />