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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date July 12, 2019 <br />_...... .....--- - ---_ <br />Name Andrew Netter <br />Department DCI <br />Division/Bureau Planning <br />BPW Date July 23, 2019 Phone Extension 5931 <br />u. rvrarrrv;nrmmmr»;ra���rauwe7u�inmwwurrwounKuw�u�muvrivrnmm;rwe.�ae �r �e.-sa,.. m�ww�;:rcn...—�.uvn.:.euww�r��wurvrc�rm,�r'rc,:v�!m�mrimm.., W_F,,ac__�s�arw�!immmnmmmuuuu,mrracyr��ooirrvrmmnuouoi�,rt.�uuao�o..�.�_s.��rmre!wrvvmu�u:m:a <br />_.,, <br />mm � t uired Prior to Submittal to Board — <br />Legal ® Attorney Name: Sandra Kennedy <br />Controller ❑ Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing ❑ <br />Check the <br />L] Agreement Amendment <br />® Professional Services <br />❑ Bid Opening <br />❑ Quote Opening <br />❑ Change Order No. <br />El Ease/Encroach, <br />Other: <br />Company or Vendor Name <br />iroprjate Item Type — <br />❑! Contract <br />Resolution <br />Submissions ire. or All ub onsvvv�v <br />❑ Proposal <br />El Bid Award ❑ Req. to Advertise <br />El Quote Award <br />El C/O & PCA No. ❑ PCA <br />Traffic Control: <br />New Vendor <br />MBE/WBE Contractor <br />MBE/WBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Current Percent of Change;. <br />New Amount $ <br />Total Percent of Change: <br />Required Information <br />Troye Group <br />Yes No <br />Purchasino <br />MBE LJ WBE <br />No Yes ...Name.of .. . <br />Corn <br />Vacant Lot Guide <br />EDIT <br />-11111 <br />08-10 460-41.01 <br />3.5.'.O 0.0.. <br />....._.....--------------- <br />Copy Original <br />® Andrew Netter <br />.... ._... <br />(� <br />____ <br />Dispersal After A...oraroval <br />Addendum <br />❑ Title Sheet <br />If Yes, Approved by <br />