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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 8/27/2019 Department Central Services <br />Name Adam Parsons <br />.... .......� ._—.—.. .... ...... ..m....., � .��� A.__....� .....w.w....�... <br />s Division/Bureau <br />BPW Date 9/10/2019 Phone Extension 9302�..��.�.�.r. ....................... <br />Ic.,iwaw�ti's:�'d���� ,,, ��OANfr1k,�.�.at�-a�.'"..�I�.� '�IYd41N�Y:��VIdVW' �dtl^r—,.�'v,e,,.tiW'ild' 4�W�1�"#NI@da'�W�;�i NJi�Vf ���5u :vti�,%WYI •"°°""""°•"fiv2P '. �.�:c..a:.11M4"�+GUFN"ABIdMNNIIWI0101M!�?�4WMVVY �'._�b� ,,. 'w�m�:.,Ju� <br />4,.,. ._...,,.,... 1 1 ..................� ...... ........ m.. �... ..-_.,_,.,..m„�. .. ...... ,....,...._,._ <br />uired Prior to S bmittal to Board <br />Legal .m_.... _.. ._..w_�. <br />g ❑ Attorney Name: Clara McDaniels <br />Controller ❑ 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 ❑ <br />Check the <br />Agreement Amendment <br />El Professional Services <br />❑ Bid Opening <br />El Quote Opening <br />El Change Order No. <br />Ease/Encroach. <br />C� Other: <br />Company or Vendor Name <br />1roprtat..AeaType .:. <br />Contract <br />El Resolution <br />El Bid Award <br />F] Quote Award <br />F] C/O &PCANo. <br />_ <br />FI Traffic Control: <br />New Vendor <br />MBE/WBE Contractor <br />MBE/WBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Brown ._B r....Gen own General --- <br />Amount of [:] Increase $ <br />Decrease $ <br />Previous Amount $ <br />for All Submissions <br />Proposal <br />Req. to Advertise <br />Addendum <br />❑ Title Sheet <br />