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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 3/011/ 19 <br />Name Loa Timmer Department DCI <br />BPW Date 3/ 19 Phone Extension 5841 <br />Refit°ed Prior to Submittal to Board <br />BPW Attorney ® Attorney Name Clara McDaniels <br />Dept. Attorney <br />Purchasing <br />Check th <br />Professional Services Agreement <br />E, Open Market Contract <br />Bid Opening <br />E] Quote Opening <br />❑ Proposal Opening <br />7 Chg. Order, No. <br />(1 Other: <br />Attorney Name <br />Michael Schmidt <br />to Item fy`:...: <br />Contract <br />Sandra Kennedy <br />Amendment/Addendum <br />Bid Award <br />E] Quote Award <br />C/O & PCA No. <br />❑ Traffic Control <br />Company or Vendor Name Rebuilt: <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />red Information <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 />ether of St. Josc h C <br />Inc. <br />❑ Title Sheei <br />Yes H If Yes, Approved by Purchasing <br />® No <br />MBE ❑ WBE Completed E-Verify Form Attached ® Nos <br />Rebuilding Together Program <br />.. <br />19-JC-13 <br />Community Development Block Grant (CDBG) <br />�......................... _ .................._ __..... <br />212.1001.460.39.30 <br />$130,000 <br />19 — 12/31/19 <br />Provide home repairs for low -moderate income owners in the Far West Sid <br />nei hborhood <br />For Chqge Orders Owl.........._ <br />AIncrease $ <br />Amount of <br />Decrease �� � <br />Previous Amount $ <br />Increase /o <br />Current Percent of Change: Decrease (ITmmmmmmmmm%) <br />New Amount $ <br />.. ................ ............ <br />Increase %. <br />__. <br />Total Percent of Change: Decrease <br />Time Extension Amount: <br />....................... <br />New Completion Date: <br />