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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 2/20/2020--------.— <br />Department <br />Alke1na Aldridge <br />DCI <br />—Name........— <br />February <br />25, 2020 <br />(February 20'1' <br />BPW Date Review <br />Phone Extension 5896 <br />- - -------------- <br />Review w an Submittal to Board <br />Diversity Compliance <br />Z <br />_Ap <br />Officer Name <br />Michael Patton/Aladean DeRose <br />and In Officer <br />BPW Attorney <br />z <br />Attorney Name <br />................................. <br />Clara McDaniel <br />......... . . .... .... ... <br />Dept. Attorney <br />Z <br />Attorney Name <br />Sandra fennel <br />Purchasing <br />. <br />Z <br />.............. <br />Amanda Pietsch <br />. ................................... ... .... . ...........ww <br />Check the Appropriate Item Type — <br />Z Professional Services Agreement E] Contract <br />F] Open Market Contract <br />El Amendment/Addendum <br />F-1 Bid Opening <br />E] Bid Award <br />E] Quote Opening <br />E] Quote Award <br />Proposal Opening <br />F-IC/0 & PCA No. <br />Chg. Order, No. <br />F-1 Traffic Control <br />E] 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 />LJ Proposal <br />E] Special Purchase, QPA <br />❑ Req. to Advertise <br />Reject Bids/Quotes <br />PCA <br />E] Resolution <br />Ease./Encroach <br />0 Title Sheel <br />Neighborhood Resources & Technical Services Corporation, Inc. DBA <br />The .Nei w��borhoo�i Resources Connection (NRC) <br />.......... <br />F1 Yes] If Yes, Approved by Purchasing <br />Z No <br />❑MBE Completed E-Verify Form Attached Yes <br />WBE No <br />Neighborhood Resources Connection- Neighborhood Programming & <br />Capacity Building <br />... ..... . . ...................... <br />Neiborhood OrRanization Sypp <br />.. ......................... ........ ............... <br />408-1004-460.39-30 <br />. ....... . . . .......... <br />$80,000 (not to exceed) <br />. ....... . ........ ...... ................... <br />January 1, 2020- December 31, 2020 <br />I For ChnLe Orders my . .... <br />Amount of El Increase . ........... ........ . ......... <br />Decrease <br />Previous Amount <br />Increase % <br />.... ........... <br />Current Percent of Change: Decrease ... ................ . <br />New Amount <br />Increase % <br />.......... <br />Total Percent of Change: Decrease %) <br />Time Extension Amount: <br />New Completion Date: <br />. . ......... .... . Completion . ........... . . ....... . . . . . ...... ...... <br />