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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />............. . <br />Date 5/20/19 ............................. <br />Department Code <br />Name Tracy Skibins Enforcement <br />BPW Date MflV 23, 2019 Phone Extension 9325 <br />MMEHHH1 <br />Required Prior to Submittal to Board <br />_vvv <br />BPW Attorney ❑ Attorney Name <br />Dept. Attorney Attorney Name Thomas E Panowicz <br />I�] ITmm- .................... <br />Purchasing <br />Check theAppropriate <br />Item Ty��.dri <br />EJ Professional Services Agreement n Contract <br />El Open Market Contract <br />El Amendment/Addendum <br />Bid Opening <br />Bid Award <br />[� Quote Opening <br />Quote Award <br />Proposal Opening <br />❑ C/O & PCA No. <br />❑ Chg. Order, No. <br />❑ Traffic Control <br />Other: <br />Information <br />Company or Vendor Name <br />bl- All Submissions <br />Proposal <br />F-1 Special Purchase, QPA <br />® Req. to Advertise ❑ Title Sheet <br />❑ Reject Bids/Quotes <br />❑ PCA <br />❑ Resolution <br />1-1 Ease./Encroach <br />New Vendor ❑ Yes❑ If Yes, Approved by Purchasing <br />No <br />MBE/WBE Contractor � MBE Completed E-Verify Form Attached F❑ Yes <br />No <br />lowing Services for the De artment of Code Enforcement <br />Project Name RFP Tows _................................ <br />Project Number <br />Funding Source Ai i°UOVID <br />_.... <br />Account No. <br />Amount _ <br />Terms of Contract <br />Purpose/Description Z' \1 w�- <br />For `l i Orders Only <br />Increase $ ... <br />Amount of Decrease ....... �.... ........ ......... <br />(' <br />Previous Amount $ <br />Increase /o <br />Current Percent of Change: Decrease <br />New Amount $ <br />Increase % .................... w ..... . <br />�. .._.M ................ ....__...... <br />Total Percent of Change: Decrease..._ .. %) <br />Time Extension Amount: <br />New Combletion Date: <br />