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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />01/11/19 <br />Div. Chief Tim Lancaster <br />Department SBPD <br />BPW Date 01/22/19 Phone Extension 9301 <br />.. Required Prior to Submittal to Board <br />Legal ® Attorney Name Clara McDaniels <br />Controller ® Controller review is required for all Contracts $5,000.00 or more anc <br />greater than one year in length per the City Purchasing Policy <br />Purchasing <br />Check the A <br />"❑'' Agreement <br />F Professional Services <br />F Bid Opening <br />❑ Quote Opening <br />Change Order No. <br />Ease/Encroach. <br />Other: <br />rroriate Item Type <br />Contract <br />0 Resolution <br />❑ Bid Award <br />❑ Quote Award <br />❑ C/O &PCANo. <br />❑ Traffic Control <br />for All Submissions <br />J Proposal E Addendum <br />❑ Req. to Advertise ❑ Title Sheet <br />Rewired Information <br />❑ PCA <br />Company or Vendor Name Shein Realty <br />New Vendor <br />❑ Yes ® No If Yes, Approved by Purchasing <br />MBE/WBE Contractor <br />❑ MBE ❑ WBE <br />MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company <br />Project Name <br />ATF ProjectDisarm Taskforce ....-................... ......... <br />Project Number <br />Funding Source <br />Continuing Education Fund — amount is %100 reimbursed b ATF <br />�.. <br />Account No. <br />220-0801-421.39-89 <br />Amount <br />� <br />$ 10,79ITIT.._.—....._... ....— ............... — .._ <br />5.00 <br />Terms of Contract <br />One -gear renewal ..............._.. _....... .... <br />Purpose/Description <br />ATF Disarm Task Force lease renewal for calendar vear 2019. <br />Reimbursed by ATF. <br />E Required Contractor's Certification Form Attached (Non - <br />Collusion Non Discrimination, Non -Debarment, E-Verify, Ilran, etc. <br />required For ChanOr ors�...Oo.. <br />Amount of El <br />Increase $ <br />Decrease $ <br />Previous Amount <br />$ <br />�n....__......................... <br />Current Percent of Change: % <br />New Amount $ <br />................ <br />Total Percent of Change: % <br />After <br />Dispersal �...............��� p r Approval <br />Copy Original <br />❑ Div. Chief Tim Lancaster <br />❑......................................... <br />