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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 2/09/19 <br />_... .......... ..... Name _ Lory Timmer Department DCI <br />BPW Date 2/26/19 Extension <br />Phone Extens... <br />5841 <br />..� .ReqWred RequiredPrior to Submittal to Board <br />BPW Attorney ® Attorney Name Clara McDaniels <br />Dept. Attorney ® Attorney Name Sandra Kennedy <br />Purchasing ® Michael Schmidt <br />4�:, �l f. t <br />El Professional Services Agreement ® Contract <br />❑I Open Market Contract El Amendment/Addendum <br />E] Bid Opening Bid Award <br />❑ Quote Opening Quote Award <br />Proposal Opening ❑j C/O & PCA No. <br />❑ Chg. Order, No. Ell Traffic Control <br />[� Other: <br />l e eq..Information <br />ma <br />All Submissions <br />Proposal <br />Special Purchase, QPA <br />❑ Req. to Advertise <br />Reject Bids/Quotes <br />PCA <br />❑ Resolution <br />Ease./Encroach <br />❑ Title Sheei <br />Company or Vendor Name <br />Habitat for HUnianitt of St Jose�'c�u�I Inc. <br />_...... m _ <br />New Vendor <br />......._ m ... .... <br />1:1 Yes If Yes, Approved by Purchasing <br />® No <br />MBE/WBE Contractor <br />❑ MBE Completed E-Verify Form Attached ® Yes <br />F-1 No <br />Project Name <br />J <br />Rehabilitation o f a Foreclosed Llrop+��� <br />Project Number <br />Funding Source <br />Nehborhood Stabilization Program 3 (NSP3�i. <br />Account No. <br />..... <br />212.1001.460.39.30 <br />Amount <br />Terms of Contract <br />1/01/19 12/31/19 <br />Purpose/Description <br />_Provide development subsidy to rehab the foreclosed property at <br />1217 Miner Street, to be sold to a low -mod income buyer <br />.... For C��Orders <br />_�_...._..____w ....�illy <br />IncreaseAmount of .... .... ❑l Decrease ($ <br />Previous Amount $ <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />New Completion Date: <br />Increase % <br />Decrease % <br />Increase % <br />Decrease <br />