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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 4/09/2020 <br />Department DCI <br />Name Pam Meyer <br />BPW Date 4/14/2020 Phone Extension 5845 <br /> <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance <br /> Officer Name Michael Patton <br />and Inclusion Officer <br />BPW Attorney Attorney Name Clara McDaniels <br />Dept. Attorney Attorney Name Sandra Kennedy <br /> <br />Purchasing Michael Schmidt <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 <br />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: License Agreement Ease./Encroach <br />Required Information <br />Company or Vendor Name Department of Community Investment <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 COVID Quarantine Site <br />Project Number <br />Funding Source <br />Account No. 408-0401-415.39.30 <br />Amount $270,000.00 -not to exceed <br />Terms of Contract 04/14/2020 05/14/2020 <br />Purpose/Description Provides for temporary emergency shelter for those awaiting test results <br />and/or recovering from COVID -19 who have no home to go to and need <br />a place to shelter in place away from others <br />For Change Orders Only <br />$ <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 />