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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />September 3 2019 <br />Cara Grabowski <br />Public Works <br />BPW Date Next Available Phone Extension 5819 <br />MMAmviuimuuwimwN mu�plmwgsuuuuuuuuuuuuuuuummmuanffi m muiwvmuwionr. <br />'Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Clara McDaniels <br />Dept. Attorney Attorney Name <br />Purchasing �] <br />Check the Ay rom i to Item Tw A <br />® Professional Services Agreement Contract <br />Open Market Contract ❑ Amendment/Addendum <br />�Bid <br />Opening Bid Award <br />] <br />Quote Opening Quote Award <br />Proposal Opening [❑ C/O & PCA No. <br />❑ <br />Chg. Order, No. ❑ Traffic Control <br />[] 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 />Purpose/Description <br />All Submissions <br />LJ Proposal <br />E] Special Purchase, QPA <br />F] Req. to Advertise ❑ Title Sheet <br />Reject Bids/Quotes <br />F]PCA <br />Resolution <br />Ease./Encroach <br />Austin Collins, CSC _ <br />❑ Yes ❑ If Yes, Approved by Purchasing .................._�.................................�.�.�........ <br />No <br />]! MBE Completed E-Verify Form Attached El Yes <br />[] WBE ❑ No <br />Roundabout Art Pilot <br />404-1001-460.42-03 <br />Agreement to loan sculptures for two roundabouts for a public art pilot. <br />Fors h <br />Amount of m .. <br />Increase $ � . <br />Decrease <br />Previous Amount $ _ <br />Increase......................_�..............���.__w. ° �..................................................�.�.�.�..............�.............................�......_..._.. <br />�o <br />Current Percent of Change: Decrease . ���%) <br />New Amount $ <br />Increase % <br />Total Percent of Change: Decrease ( /o)����� <br />Time Extension Amount: <br />New Completion Date: <br />