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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date7/3/19,..........-.............__....................................... ...... ����.R <br />Naive Adam Parsons Central Services <br />BPW Date 7/23/19 Phone Extension 9302 <br />df�GY %V✓Vord.::�...�c.�ar',»,^ m v unuwour:�..�iflGM1�YM✓+MdiYif�YlW dlldf ....��. ._� vurnT_sm�➢ri:M^.riTWOhY�4849!IfW+�ld�,'f!!J!0'dY�ddOlP�bi�ONIN0101W911W.9VI0MBItlFIYVIVYfrPdLilltk:;:-.:2+Iv.z.i .. ,.c5 '�iGIDrr"" �::;�s�un,,,z.�vna_v.2.m'(';�:.�;L�IIYIMYIYIYIMYIG"Y,�OfuTufl�� <br />_.. ,,....,,... ........� ..... .....�,. .,.,e weep .......,...r _..._._....... ........ ... �,�......,.e.,..,..,........ <br />Retluired yPrior to Submittal to Board <br />,.. _.m .. ,...-...�..............—.....,� .. ��.. <br />BPW Attorney X Attorney Name Clara McDaniels <br />Dept. Attorney El Attorney Name <br />Purchasing <br />r.Pr Check the A„pproprxate <br />Item„I..,e Re n <br />Professional Services Agreement <br />Contract <br />Open Market Contract <br />® Amendment/Addendum <br />❑ Bid Opening <br />❑ Bid Award <br />E] Quote Opening <br />Quote Award <br />Proposal Opening <br />[ C/O & PCA No. <br />Chg. Order, No. <br />❑ Traffic Control <br />X Oth <br />er: Release Easement <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 />Tenns of Contract <br />Purpose/Description <br />Required Information <br />All Submissions <br />Proposal <br />❑ Special Purchase, QPA <br />Req. to Advertise <br />Reject Bids/Quotes <br />I❑ PCA <br />Resolution <br />Ease./Encroach <br />❑ Title Sheei <br />Inc. <br />mIT� m isand Crum Architects,:...� <br />Yes If Yes, Approved b Purchasing <br />No <br />MBE Completed E-Verify Form Attached Yes <br />WBE F] No <br />County -City Building_ Remodel <br />Code Enforcement <br />600-0640-658.31-02 <br />„mmm-.................................. <br />$3,000 <br />Additional project fees to finalize documentation and bidding specification, <br />for Code Enforcement vestibule. <br />.. ....... �� ms�... �..�..... <br />For Change Orders Only <br />Amount of Increase $ <br />❑ Decrease ($ ) <br />Previous Amount $ <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />New Completion Date: <br />Increase <br />% <br />Decrease.............% <br />Increase <br />/o <br />Decrease <br />( % <br />