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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date Decemb�er 16,2019 <br />Name Chris Dressel Department DCI <br />.......... . . . ....... <br />BPW Date December 19 2019 Phone Extension 5847 <br />�ff�lRuimimiIN paW@WOWWgMIWIWfN ffi <br />ubmittal to Board <br />BPW Attorney Attorney Name Clara McDaniel's- <br />Dept. Attorney Z Attorney Name Sandi Kennedy <br />.................. . . ...... <br />Purchasing Z Katy Raj ski <br />Check the Apl)rpp��m Tye.-- cat is <br />Professional Services Agreement Z Contract <br />[:] <br />Open Market Contract E] Amendment/Addendum <br />E] <br />Bid Opening n Bid Award <br />E] <br />Quote Opening ] Quote Award <br />n <br />Proposal Opening CIO & PCA No. <br />E] <br />Chg. Order, No. Traffic Control <br />n 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 />uired Information <br />All Submissions <br />E] Proposal <br />E] Special Purchase, QPA <br />0 Req. to Advertise <br />E] Reject Bids/Quotes <br />0 PCA <br />E] Resolution <br />Ease./Encroach <br />0 Title Sheet <br />Burkhart Advertisi.nS.... <br />O—Y-e-s[J—IfYe�­Approved by Purchasing <br />No <br />E] MBE Completed E-Verify Form Attached Yes <br />F-1 WBE ] No <br />Census 2020 Billboard Advertising <br />COIT <br />.......... . . . .. . 404.1050..460.31.06 <br />$10,000 - - ------- - --------- . .... . ........... Through 12/3-1/20 <br />Billboard advertising to aid local outreach during the Census 2020 self - <br />response period. <br />For,Ch,aqOrderswOnly. . . ... . ........ <br />Amount of Fj <br />increase $ <br />. ................. ...... ... <br />El <br />Decrease <br />........... <br />Previous Amount <br />$ <br />Increase <br />% <br />Current Percent of Change: <br />Decrease <br />%) ............ . . <br />New Amount <br />$ <br />Increase <br />% <br />Total Percent of Change: <br />Decrease <br />...... — %) <br />Time Extension Amount: <br />New ComDletion Date: <br />