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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 04/07/2020 <br />Department Innovation & Technology <br />Name Brian Donoghue <br />BPW Date 04/14/2020 Phone Extension 7652 <br /> <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance <br /> Officer Name Patton <br />and Inclusion Officer <br />BPW Attorney Attorney Name McDaniels <br />Dept. Attorney Attorney Name Kennedy <br /> <br />Purchasing <br />Check the Appropriate Item Type Required for All Submissions <br /> Professional Services Agreement Contract 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 /> Other: Ease./Encroach <br />Required Information <br />Accion Serving Illinois and Indiana <br />Company or Vendor Name Contact: Brad McConnell bmcconnell@accionchicago.org <br /> Yes If Yes, Approved by Purchasing <br />New Vendor <br /> No <br /> MBE Yes <br />MBE/WBE Contractor Completed E-Verify Form Attached <br /> WBE No <br />Project Name Emergency Small Business Assistance <br />Project Number <br />Funding Source EDIT & Redevelopment General (Pokagon) <br />Account No. 408-1050-460.39-30& 433.1050-460.39-30 <br />Amount $ 390,000 <br />Terms of Contract 4/14/2020 4/14/2022 <br />Purpose/Description Agreement for the development and execution emergency small business loan <br />program________________________________________________________ <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 /> <br />New Amount $ <br /> % <br />Increase <br />Decrease ( %) <br />Total Percent of Change: <br /> <br />Time Extension Amount: <br />New Completion Date: <br />