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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />December 17 2019 <br />Elicia Feasel <br />Department DCI <br />BPW Date December 19 2019 Phone Extension 5845 <br />.. m_� .... <br />ReA uird Prior to Submittal to Board <br />............. ., _._...... ...... <br />BPW Attorney ❑ Attorney Name McDaniels <br />Dept. Attorney F-1 Attorney Name Kennedy <br />Purchasing El <br />Check the riat.e Item '1 �e�1 aim' l- All Submissions <br />Professional Services Agreement 0 Contract ❑ Proposal ._ ..._..__. __ <br />Open Market Contract F'J Amendment/Addendum ❑ Special Purchase, QPA <br />E, Bid Opening E] Bid Award Req. to Advertise ❑ Title Sheel <br />R Quote Opening Quote Award Reject Bids/Quotes <br />Proposal Opening C/O & PCA No. ❑ PCA <br />❑ Chg. Order, No. ❑ Traffic Control x Resolution <br />.�.._._,_,___ .._..._.,...... ach <br />Other: _ _.._ Ease./Encroach <br />IT Required Information <br />Company or Vendor Name _ <br />New Vendor❑ Yes❑ If Yes, Approved by Purchasing_._....._.... <br />❑ No <br />MBE/WBE Contractor ❑❑ MBE Completed E-Verify Form Attached Nos <br />Project Name <br />.................. ....... _ ...__..._ <br />Project Number..._...... <br />......_ .... � � � � . .........�� _. _...�........... <br />Funding Source <br />Account No. <br />Amount,.,,, �.._�...._�........ �_ _....�...���_ <br />Ws ....... .............. <br />Terms of Contract <br />Purpose/Description Resolution to declare certain City ro ertheld bv the Historic Preserva6 <br />Commission valueless and to allow its donation to willin recipients or <br />otherwise authorize its dis osa , <br />For Ct n e Orders 0111 <br />Amount of Increase $www ..m <br />❑ <br />❑' Decrease ($ <br />Previous Amount $ <br />Increase % �-._..................._ <br />............ _ .. _ ..............a.a.aw <br />Current Percent of Change: Decrease %) <br />New Amount $ <br />�............................ <br />Increase % <br />Total Percent of Change: Decrease <br />Time Extension Amount: _.... <br />New Completion Date: <br />