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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 8/28/19 <br />Name Scott Kree <br />Department Public <br />Works <br />BPW Date 9/10/19 Phone Extension 9245 <br />__ .m._ _......v._.v _.___...m......m_. Re q! uired Prior to Submittal to Board <br />BPW Attorney Attorney Name Clara McDaniels <br />Dept. Attorney Attorney Name <br />Purchasing <br />Check the Appropriate Item Type <br />Professional Services Agreement ❑ Contract <br />❑] Open Market Contract <br />[❑ Amendment/Addendum <br />❑ Bid Opening <br />Bid Award <br />Quote Opening <br />E] Quote Award <br />Proposal Opening <br />❑ C/O & PCA No. <br />Chg. Order, No. <br />® Traffic Control: <br />Residential 1-Iandicap <br />Parkin <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 />Information <br />All Submissions <br />Proposal <br />�I Special Purchase, QPA <br />�] Req. to Advertise <br />Reject Bids/Quotes <br />❑ PCA <br />❑ Resolution <br />Ease./Encroach <br />❑ Title Sheet <br />Yes If Yes, Approved by Purchasing <br />No <br />MBECompleted E-Verify Form Attached Nos <br />511 S Grant St. Residential Handicap Parking <br />Recommend Approval <br />For Chang Orders Only . .... � .. <br />....... ......_..._........... . <br />Amount of Increase $ <br />❑ Decrease ($ 1 <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount:. <br />New Completion Date: <br />Increase <br />% <br />Decrease <br />Increase �...........�.��......._%� <br />.. % <br />Decrease <br />( % <br />