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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 8/5/19 <br />Name Scott Kree <br />Department Public <br />Works <br />BPW Date 8/13/19 Phone Extension 9245 <br />__._ <br />Icgward Pnor to Submittal to Board <br />BPW Attorney Z Attorney Name Clara McDaniels <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ® Michael Schmidt <br />Check the Appropriate Item Type -- <br />Professional Services Agreement Contract <br />F-1 <br />Open Market Contract ❑ Amendment/Addendum <br />❑ <br />Bid Opening Bid Award <br />Quote Opening ❑ Quote Award <br />[� <br />Proposal Opening C/O & PCA No. <br />Chg. Order, No. Traffic Control <br />® Other: P'ublic Notice of <br />Intent to Self-nerforin Pavinp <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 />All Submissions <br />Proposal <br />Special Purchase, QPA <br />Req. to Advertise ❑ Title Sheet <br />Reject Bids/Quotes <br />�] PCA <br />❑ Resolution <br />❑ Ease./Encroach <br />...................................ww.....� -- <br />.Yes f Yes, Approved by Purchasing <br />❑ No <br />For Chit o Qrders <br />Amount of ❑ Increase $ <br />Decrease ($ ) <br />Previous Amount $ <br />_.... o .. ............ — w <br />Increase /o _ <br />................... �.... m.....--------------------- ��� uu. <br />Current Percent of Change: Decrease /o � ......... <br />New Amount $ <br />Increase % <br />Total Percent of Change: Decrease .....-_________%�......_.,.........mm .................��.���........ w <br />Time Extension Amount: <br />New Completion Date: <br />