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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date October 1, 2019 <br />Name And .............._. <br />rew Netter <br />Department DCI <br />Division/Bureau Planning <br />BPW Date October 8, 2019 Phone Extension 5931 <br />14�NIIMIIIIIIIIIIIIIIIIIIIIIIIIIYYbMNYANXAIXN/hH/MXJri➢fit Ylded�,ry,�,yWWWWyWIV N— i �p�yry�, ppq ,�� ��y����p ��� <br />.......,.�,.........,.....W.........�...�,,,,, ....Wu.... <br />Required to Submittal to _ <br />Prior __.. <br />.._.._... ....��...w .��.,.. � Board <br />Legal ® 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 Appropriate Item "yp — Required uired for All Submissions <br />F-1 Agreement �...._.......��_� [] Proposal ❑Addendum <br />Professional Amendment Contract <br />Services Resolution <br />Bid Opening [:] Bid Award ® Req. to Advertise ❑ Title Sheet <br />Quote Opening F] Quote Award <br />El Change Order No. ❑l C/O & PCA No. ❑ PCA <br />F_�' Ease/Encroach. E ]I Traffic Control: <br />Other: <br />Required Information <br />Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />... ......... ,.... ........ ... 0r <br />El <br />Amount of Increase ��.....� <br />Previous Amount Decrea $ m, 4U Wuo VED �.. <br />1 -...�tt� .... <br />Current Percent of Change: % <br />New Amount <br />Total Percent of <br />Copy <br />Original <br />® <br />❑ <br />El <br />❑ <br />❑ <br />❑ <br />Andrew Netter <br />Dispersal After App <br />roval <br />