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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date April 6, 2020 <br />Name Aaron Perri Department VPA <br />BPW Date April 14, 2020 Phone Extension Ext. <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance ❑ <br />Officer Name <br />and Inclusion Officer <br />BPW Attorney ® Attorney Name Clara McDaniels <br />Dept. Attorney ® Attorney Name Clara McDaniels <br />Admin and Finance ❑ Daniel Parker <br />Check the Appropriate Item Tvbe — Reauired for All Submissions <br />U Professional Services Agreement N Contract U Proposal <br />❑ Open Market Contract ❑ Amendment/Addendum ❑ Special Purchase, QPA <br />❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening ❑ Quote Award ❑ Reject Bids/Quotes <br />❑ Proposal Opening ❑ C/O & PCA No. ❑ PCA <br />❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution <br />n Other: n Ease./Encroach <br />Information <br />Company or Vendor Name Stanz FoodService Inc. <br />New Vendor ❑ Yes ❑ If Yes, Approved by Purchasing <br />❑ No <br />MBE/WBE Contractor ❑ ❑ <br />MBE Completed E-Verify Form Attached ❑ Yes <br />No <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount $50,000 <br />Terms of Contract <br />Purpose/Description Agreement to pay $50.000 to Stanz Food Service to cover the cost of <br />providing food products to area food banks and other non -profits in response <br />to COVID-19 pandemic. <br />For Change Orders Only <br />Amount of ❑ Increase $ <br />❑ Decrease ($ ) <br />Previous Amount $ <br />Current Percent of Change: <br />New Amount <br />Increase <br />Decrease <br />Increase <br />Total Percent of Change: Decrease <br />Time Extension Amount: <br />New Completion Date: <br />