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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 5/21/19 <br />Name Liz Maradik Department DCI <br />BPW Date 5/28/19 Phone Extension x5821 <br />Req� iced Prior to Submittal to Board <br />BPW Attorney <br />� ..._ .._ m� .�....._.._.�..� �6 ,,...� ............... ... <br />❑ Attorney Name <br />Dept. Attorney Z Attorney Name Sandi Kennedy <br />------ ........... ........... --- .......... ______- <br />Purchasing <br />Check the <br />❑ Professional Services Agreement <br />❑ Open Market Contract <br />0 Bid Opening <br />❑ Quote Opening <br />Proposal Opening <br />❑] Chg. Order, No. <br />Z Other: MOU <br />le Item���� �. <br />Contrac <br />t <br />El Amendment/Addendum <br />❑ Bid Award <br />❑ Quote Award <br />C/O & PCA No. <br />Traffic Control <br />Pired. Information <br />All Submissions <br />Proposal <br />Special Purchase, QPA <br />E] Req. to Advertise <br />0 Reject Bids/Quotes <br />E PCA <br />Resolution <br />Ease./Encroach <br />Company or Vendor Name Board of Commissioners of St Joseph Co <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 />❑ Title Sheet <br />YesE] If Yes, Approved by Purchasing <br />® No <br />❑ MBE Completed E-Verify Form Attached ❑ Yes <br />❑ WBE [:] No <br />TTransfer of Tax Delinquent Properties r„r <br />... - .... <br />COIT <br />404- 60-41.01 <br />....................................... <br />NTE $109,200 <br />Administrative cost to complete transfer of 84 tax delinquent properties to tl: <br />City <br />....w ...... <br />...For rng. Orders Only <br />.... � � <br />Amount of <br />Increase $ <br />El <br />Decrease ($ <br />Previous Amount <br />_ _ <br />$ <br />......Increase <br />............. __. .......... ....... _ . -.....e- ............................. <br />...................___......_m.,.....................................................�.�.�.�.�....� <br />._n.._,...........�......-_ <br />.. % <br />Current Percent of Change: <br />Decrease <br />0 <br />( /o) <br />New Amount <br />$ ........................ <br />..._.......... ........... ... <br />.....���.... __.�..._._. �... <br />Increase <br />se <br />% <br />Total Percent of Change: <br />Decrease <br />..... ........ ..... <br />%) <br />Time Extension Amount: <br />........................ _____-____......_ <br />New Completion Date: <br />