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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 04/02/2019 <br />Name Dan Buckenmevei- Department DCI <br />- — ---------- . . . . . ................. <br />BPW Date 04/09/2019 Phone Extension 5328 <br />R uired Prior to Submittal to Board <br />BPW Attorney Attorney Name <br />Dept. Attorney F-1 Attorney Name Sandra Kenned <br />Purchasing F-1 <br />Check the <br />Item Type -- Requiredfiv All Submissions <br />F-� Professional Services Agreement Z Contract <br />F-1 <br />Open Market Contract 0 Amendment/Addendum <br />E] <br />Bid Opening E] Bid Award <br />R <br />Quote Opening Quote Award <br />E] <br />Proposal Opening ❑ C/O & PCA No. <br />[:] <br />Chg. Order, No. F-1 Traffic Control <br />E] Other: <br />Company or Vendor Name <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 />Information <br />CNA Traini <br />U Proposal <br />E] Special Purchase, QPA <br />Req. to Advertise <br />Reject Bids/Quotes <br />PCA <br />E] Resolution <br />Ease./Encroach <br />0 Title Sheet <br />H Yes LJ If Yes, Approved by Purchasing <br />Z No <br />E] MBE Completed E-Verify Form Attached ❑ Yes <br />Fj WBE ❑ No <br />Pathways Program <br />EDIT <br />404-1001-460-39.30 <br />$38,000 <br />Training program to train necessary skills to under skilled workers to meet <br />labor needs in the community <br />. . ......... <br />For Change Orders Only <br />Amount of F-1 increase ............ <br />El Decrease <br />Previous Amount <br />....... . . ......... <br />Increase % <br />Current Percent of Change: Decrease %) <br />. ........ <br />New Amount <br />increase % <br />Total Percent of Change: Decrease <br />Time Extension Amount: <br />New Completion Date: <br />-------------- <br />