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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date04/07/2020 <br />DepartmentInnovation & Technology <br />NameBrian Donoghue <br />BPW Date04/14/2020Phone Extension7652 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance <br />Officer NamePatton <br />and Inclusion Officer <br />BPWAttorneyAttorney NameMcDaniels <br />Dept. AttorneyAttorney NameKennedy <br />Purchasing <br />Check the Appropriate Item Type Required for All Submissions <br />Professional Services AgreementContractProposal <br />Open Market ContractAmendment/Addendum Special Purchase, QPA <br />Bid OpeningBid AwardReq. to AdvertiseTitle Sheet <br />Quote OpeningQuote AwardReject Bids/Quotes <br />Proposal OpeningC/O & PCA No. PCA <br />Chg. Order, No. Traffic ControlResolution <br />Other: Ease./Encroach <br />Required Information <br />CDFI Friendly America LLC <br />Company or Vendor NameContact: Mark Pinsky <markpinsky@gmail.com> <br />YesIf Yes, Approved by Purchasing <br />New Vendor <br />No <br />MBEYes <br />MBE/WBE ContractorCompleted E-Verify Form Attached <br />WBE No <br />Project NameCDFI Friendly City <br />Project Number 19J003 <br />Funding SourceRedevelopment General (Pokagon) <br />Account No.433.1050-460.39-30 <br />Amount <br />Terms of Contract11/15/2019 12/31/2020 <br />Purpose/DescriptionAmendment ofthe Services Agreement to reflect the Contractor's name <br />change <br />_______________________________________________________________ <br />_______________________________________________________________ <br />________________________________________________ <br />For Change Orders Only <br />$ <br />Increase <br />Amount of <br />Decrease($) <br />Previous Amount$ <br />% <br />Increase <br />Decrease(%) <br />Current Percent of Change: <br />New Amount$ <br />% <br />Increase <br />Decrease(%) <br />Total Percent of Change: <br />TimeExtensionAmount: <br />