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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date October 15, 2019 <br />Name Alke na Aldrid e <br />Department DCI <br />BPW Date October 22, 2019 Phone Extension 5896 <br />ou����r�-. �-,... .��w�w„,. �� '��m:�aran .emw' u��u�,m�uuuuuuuuuuuuuumWmWmWuuuuuWuuiuiuuuwwww.mMww�!�,m�,*u�,emauauu��— ,.�., , ......��yuiW�w�uuww��mmuimimmmuuuuuuuuuuuuumimimimimiminun mvmar�rvmye,�,mw,�v....-. <br />..W,_..�....... <br />am.. .. .. ........................... <br />Required Prior to Submittal to Board <br />Legal Z <br />Attorney Name Sandra Kennedy <br />Controller z <br />Controller review is required for all Contracts $5,000.00 or more anc <br />greater than one year in length per the City Purchasing Policy <br />Purchasing <br />w Check the pro riate Item 1y�p IT Required for All Submissions <br />�._ <br />Agreement <br />❑ Contract [ Proposal Addendum <br />El Professional Services <br />❑ Resolution <br />Fl Bid Opening <br />❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />El Quote Opening <br />❑ Quote Award <br />El Change Order No. <br />El C/O & PCA No, ❑ PCA <br />El Ease/Encroach. <br />E] Traffic Control <br />[I Other <br />Company or Vendor Name <br />Initiative <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 />Required Information <br />St. Mary's College Women's Entrepreuneurship <br />® Yes ❑ No ❑ If Yes, Approved by Purchasing <br />❑ MBE ® WBE <br />_Spark Women's Business Accelerator Neighborhood Pilot <br />19J002 <br />_........__ ......... .... ._.......... <br />Redevelopment General (Pokagon) <br />...�._... ..............._... <br />433.1050-460.39-30 <br />511 Oot ....tO� .�...�0 t _.�. .............. mm..... <br />.......................... August 27 2019- De. 31, 2020 <br />.�...........:.........._._._._._._. <br />Place -based, minority small business accelerator pilot related to the <br />Engagement & Empowerment team's goals. <br />® Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verifv, Iran. etc. <br />Amount of Increase $ <br />Decrease $ <br />Previous Amount $ <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Copy <br />Original <br />El <br />z <br />El <br />Dispersal After Apprval <br />Alkeyna Aldridge <br />Amanda Pietsch <br />Daniel Parker - <br />