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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />August 1, 2019 <br />Elicia Feasel <br />Department Community <br />Investment <br />BPW Date Phone Extension 7672 <br />Required Prior to Submittal to Board <br />Legal ® Attorney Name Sandi Kennedy, Clara McDaniels <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller ® and greater than one year in length per the City Purchasing <br />Policy <br />Purchasing <br />Check the <br />Agreement <br />® Professional Services <br />Bid Opening <br />El Quote Opening <br />❑ Chg Order No. <br />0 Ease./Encroach. <br />If1 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 />roiate Item Type - <br />F ] Contract <br />El Amendment <br />n Bid Award <br />El Quote Award <br />E' C/O & PCA No. <br />F Traffic Control <br />'for All Submissions <br />Proposal <br />❑ Req. to Advertise <br />❑ PCA <br />❑ Resolution <br />Claim <br />Required Information <br />BOLT LIMITED, Inc, (preferred vendor for speis <br />❑ Yes LJ If Yes, Approved by Purchasing <br />No <br />❑ MBE Completed E-Verify Form Attached <br />® WBE <br />Historic Preservation Digitization of Records <br />n/a� <br />DC I Ad m i n <br />211-1001-460m 3106 <br />$20,000 <br />See attached <br />Addendum <br />❑ Title Sheet <br />ized services <br />❑ Yes <br />❑ No <br />Purpose/Description Scan Historic Preservation records including Files Slides <br />Negatives, Blueprints and other large scale prints. Index into <br />folders for Laserfiche or anization, <br />For Change Orders Onl` <br />Amount of F-1 Increase _$ <br />El Decrease $ <br />Previous Amount $ _ <br />Current Percent of Change: _ % <br />New Amount $ <br />Total Percent of Change: % <br />Time Extension: <br />Dispersal After Approval <br />Copy Original <br />® ❑ Judy Love, Community Investment <br />® ❑ Elicia Feasel, Community Investment <br />