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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date May 21, 2019 <br />Name Michael Divita Department DCI <br />BPW Date Ma 28, 2019 Phone Extension 5843 <br />MEW M <br />n__............... ......... <br />�..... <br />Required Prior to Submittal to Board <br />BPW Attorney Attorney Name <br />Dept. Attorney Attorney Name Sandra Kennedy <br />Purchasing <br />Check the AppTpate Item Type m. l e is°gal s All Submissions <br />0 Professional Services Agreement Contract <br />Open Market Contract <br />® Amendment/Addendum <br />0 Bid Opening <br />Bid Award <br />Quote Opening <br />❑ Quote Award <br />EJ Proposal Opening <br />C/O & PCA No. <br />E Chg. Order, No. <br />E] Traffic Control <br />❑ Other: <br />Reeuired Information <br />LJ Proposal <br />E] Special Purchase, QPA <br />❑ Req. to Advertise <br />0 Reject Bids/Quotes <br />❑ PCA <br />Resolution <br />El Ease./Encroach <br />❑ Title Sheei <br />1010 <br />Company or Vendor Name <br />JenniferL.�� 60 0 <br />If Yes, Approved b Purchasing <br />pp y g <br />New Vendor <br />® No <br />MBE/WBE Contractor <br />Completed E-Verify Form Attached ❑ Nos <br />MBE <br />Project Name <br />Zoning Ordinance Updatesnn <br />Project Number <br />. _......, .................. <br />Funding Source <br />--- <br />DCI Admin <br />Account No. <br />211.1001.460.31.06 ............ <br />/ 18J028 <br />Amount <br />$26,600 <br />Terms of Contract <br />....... ................ .......................... .. �. ..._ <br />Purpose/Description <br />Additional services to revise ('1t rITIT 'Se 1tITh Bend lonin 6�aii:�Inc lu w <br />new development standards and_ rrgphics <br />For Chap e Orders nl <br />Amount of <br />Increase $ <br />0 <br />Decrease ($ ) <br />Previous Amount <br />................................. --- .......... ................-------------------..._..._................................................. <br />$ <br />... _..Increase..........................................................................%........................................................................- <br />_............................._ .......,,........_........_... m...W._. <br />Current Percent of Change: <br />�...._.. <br />Decrease ( %) <br />New Amount <br />$ <br />Increase % <br />TotalPercent of Change: <br />Decrease....................................%)................................................................................ _. <br />Time Extension Amount: <br />m......._ <br />New Completion Date: <br />