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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date July 27, 2019 <br />Name Andrew N.....__ _- <br />etter <br />Department DCI <br />Division/Bureau Plannin <br />g <br />BPW Date 08/13/2019 Phone Extension 5931 <br />wwwwwuKxaw.mw n—.,„�muumumwuuw�u�vrrm+,.M:wrw wwjiuw�mmmrvr,.•N^-----�uwarmx <br />... _. .. <br />_-------- <br />Re aired Prior to Submittal toBoard e ...vn.. _...m <br />Legal Z <br />Attorney Name: Clara McDaniels <br />Controller El <br />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 0 <br />..... <br />Check th�� App�a� <br />-iteItemp'cr�e-.-.-_ for All Submissions <br />�❑�� <br />Agreement AgreementAmendment <br />...mm..�. � ......- �El Addendum <br />Contract Proposal <br />E] <br />Professional Services <br />Resolution YOM <br />Bid Opening <br />Bid ward ❑ Req. to Advertise ❑ Title Sheet <br />❑ <br />Quote Opening <br />E <br />Quote Award <br />F <br />Change Order No. <br />0 C/O & PCA No. ❑ PCA <br />Ease/Encroach. <br />❑ Traffic Control: <br />[] <br />Other: <br />�w m... <br />Required Information mmYY <br />Company or Vendor Name <br />RDC <br />. _..�..­ ...- �ee.» .... ....... ......__ �.��.. <br />El Yes ❑ No El If Yes, Approved by <br />New Vendor <br />Purchasing <br />MBE/WBE Contractor <br />❑ <br />MBE WBE <br />MBE/WBE Contractor Requested <br />.. .... __.-, m... __. <br />No 0 Yes Name of Compn <br />Project Name <br />. � Pro ert . from m,...m <br />Resolution om RDC <br />solution Acceptor Transfer of _�� <br />Project Number <br />_ <br />Funding Source <br />Account No. <br />Amount_____... <br />............................... _......_,... ..�.�.�.�..�..... �m...m........................ <br />Terms of Contract <br />Purpose/Description <br />................. .. . � ..... <br />Transfer of 5 RDC-owned properties (non-contiguous) that abut <br />BPW property, to BPW. 431 Allen, 528 Scott, 602 Scott, 620 <br />Scott, East Race lot. <br />.. ................. -_ �_ . <br />Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />e aired For Charge OrdersOnl,,,... <br />Amount of � <br />�..... ....�.. .��_...... <br />Increase . $ --- ��..��.......... -- � ......�.... _ rrr <br />Decrease $ <br />Previous Amount <br />$ <br />Current Percent of Change: <br />......... <br />... _... _ ........�...................... - m--_._....... ........ <br />% <br />New Amount <br />. . ..... _ ._.. .. ......m <br />$ <br />Total_ Percent of Chace <br />% <br />�.. <br />_ .��..,._ ..... .........w.. �......w�._ <br />Daspersal After Approval <br />Copy Original <br />_..___ ....... <br />® ❑ Andrew Netter <br />El' 1-1_ ...... <br />-- <br />