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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 12/19/2019 <br />Name Scott <br />Department Public <br />Works <br />BPW Date 1/14/2020 Phone Extension 9245 <br />ME mwuwf wmwarw MWwmaMo� <br />Reouired Prior to Submittal to Board <br />.......... <br />BPW Attorney ❑ Attorney Name <br />Dept. Attorney Attorney Name <br />Purchasing R <br />Check the Appropriate Item Type , <br />Professional Services Agreement 0 Contract <br />Open Market Contract 0 Amendment/Addendum <br />Bid Opening] <br />Bid Award <br />Quote Opening <br />Quote Award <br />❑ Proposal Opening <br />E] C/O & PCA No. <br />Chg. Order, No. <br />Traffic Control: <br />Residential Handica <br />a�ki m1 <br />U 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 />Information <br />All Submissions <br />Proposal <br />❑ Special Purchase, QPA <br />E] Req. to Advertise <br />EJ Reject Bids/Quotes <br />PCA <br />Resolution <br />Ease./Encroach <br />❑ Title Sheet <br />Yeso If Yes, Approved by Purchasing <br />R No <br />E] MBE Completed E-Verify Form Attached Yes <br />E] WBE No <br />226 Altgeld Street Residential HandicaIParkin <br />The removal of the handicap parking sign. <br />. For li!�'Orders col <br />Amount of Increase $� _ ...... _ ....w <br />❑ Decrease �$ <br />... <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 />W <br />Increase <br />_ % <br />�( <br />Decrease <br />Increase..........��........�........� <br />% <br />Decrease <br />( % <br />