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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date June 18 2019 <br />Department Public <br />Works <br />Charlotte Brach .Name ......... .... .... <br />BPW Date June 25 2019 Phone Extension 9246 <br />IMIIIRIIIIIIIIIIPMIIIillillilimilmillillillillillillillI <br />Required Prior to Submittal to Board <br />BPW Attorney Attorney Name <br />Dept. Attorney Attorney Name <br />Purchasing <br />Check the Appropriate Item Type <br />Professional Services Agreement ❑ Contract <br />Open Market Contract n Amendment/Addendum <br />Bid Opening El Bid Award <br />[� <br />Quote Opening ]l Quote Award <br />❑] <br />Proposal Opening n C/O & PCA No. <br />Chg. Order, No. ® 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 />All Submissions <br />Proposal <br />U Special Purchase, QPA <br />Ej Req. to Advertise <br />E] Reject Bids/Quotes <br />PCA <br />Resolution <br />E] Ease./Encroach <br />❑ Title Sheet <br />❑ Yes[] If Yes, Approved by Purchasing <br />E No <br />❑ MBE Completed E-Verify Form Attached E] No WBE <br />Career Acadetr Stgntge ......... <br />TR19-044B <br />Establish a school zone speed limit at Career Academy, add end school zone <br />signs and remove existing speed limit signs within the school zone. <br />._.......................Formm _�� Orders r�.�� <br />Amount of A..m,.e..w.,.... ............ <br />Increase $ <br />❑] Decrease 1 <br />_..m, .. .... - ... -- .....�......... . <br />Previous Amount <br />$ <br />......Increase _......................_��� <br />�,,,,,,,%... <br />Current Percent of Change: <br />Decrease <br />New Amount <br />$ ..�"� <br />..............................................w�w�..... <br />Increase� <br />Total Percent of Change: <br />Decrease <br />% <br />Time Extension Amount: <br />_. <br />New Cornoletion Date: <br />