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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />08/08/2019 <br />Patrick Sherman <br />Department VPA: F&G <br />BPW Date 08/13/2019 Phone Extension 5601 <br />NMMMPPPMMMMMMMMIMmmmwwwww�wm Hw�ml <br />i red Prior to Submittal to Boa <br />rd <br />........... .......... -- <br />Legal Z Attorney Name Clara McDaniels <br />Controller z 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 z <br />Check the <br />L," Agreement <br />El Professional Services <br />0 Bid Opening <br />El Quote Opening <br />n Change Order No. <br />El Ease/Encroach. <br />E] Other: <br />Michael Schmidt <br />TqpLiqte Item Type - Requirec <br />. . . ........ <br />E] Contract E <br />F] Resolution <br />:)r All Submissions <br />Proposal Addendum <br />El Bid Award El Req. to Advertise <br />El Quote Award <br />El C/O & PCA No. [J PCA <br />❑ Traffic Control <br />Reauired Information <br />El Title Sheet <br />Company or Vendor Name Geograph Industries Inc. <br />New Vendor El YesEl No H If Yes, Approved by Purchasing <br />MBEAA1BE Contractor F-1 MBEF-1 WBE <br />MBENVBE Contractor Requested F] NoF_1 Yes Name of Company <br />Project Name Howard Park E�ignage.and..Wp r�qi,ng yft . . ............... . .... .... <br />Project Number 1093-2019 <br />Funding Source VPA Marketing and Regional Cities <br />Account No. 201-1110-452.39-89 and 201-1111-452.42-01 <br />Amount 13 3,715.00 <br />Terms of Contract Per sianaae schedule <br />Purpose/Description Signage and .Wa)dinding at Howard Park. Agreement with RFP <br />winner <br />N Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, i nation, Non -Debarment, E-Ye��.etc.) <br />..... . ..... .. ....... <br />Required For Change Orders Only ............ __ ...... <br />................ <br />Amount of El <br />Decrease $ increase . ................ ... . ...... . ....... <br />F <br />