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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date September 17 2019 <br />Name Chartotte Brach IT Department Engineering <br />BPW Date Phone Extension 9246 .......................... <br />UPIM <br />...... <br />Required Prior to Submittal to Board <br />..._..�... _ _... _...._._.w_ ...__..._ .._.................... <br />__ <br />BPW Attorney Attorney Name <br />Dept. Attorney Attorney Name <br />Purchasing [❑ <br />Check the A. <br />Item Tie -�wR b- gar All Submissions <br />Professional Services Agreement ❑ Contract <br />Open Market Contract F-1 Amendment/Addendum <br />EJ <br />Bid Opening <br />Bid Award <br />❑ <br />Quote Opening <br />❑ <br />Quote Award <br />n <br />Proposal Opening <br />C/O & PCA No. <br />Chg. Order, No. <br />❑ <br />Traffic Control <br />Other: <br />e(wired Information <br />Amount of Increase $ <br />F1 Decrease ($ ) <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 />Decrease ( % <br />Increase % <br />Decrease �..�...............% <br />Proposal <br />Special Purchase, QPA <br />® Req. to Advertise <br />Reject Bids/Quotes <br />PCA <br />Resolution <br />Ease./Encroach <br />❑ Title Sheet <br />