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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 8/19/20 <br />Name Kyle Silveus Department Engineering <br />BPW Date 8/25/20 Phone Extension 9083 <br />Required Prior to Submittal to Board <br />Legal ❑ Attorney Name Clara McDaniels, Sandi Kennedy <br />Controller ❑ Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing ❑ Michael Schmidt <br />Check the Appropriate Item Type — Required for All Submissions <br />® Agreement ❑ Contract ❑ Proposal ❑ Addendum <br />❑ Professional Services ❑ Resolution <br />❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening ❑ Quote Award <br />❑ Change Order No. ❑ C/O & PCA No. ❑ PCA <br />❑ Ease/Encroach. ❑ Traffic Control <br />I-1 Other: <br />uired Information <br />Company or Vendor Name Greenleaf Holdco, LLC <br />New Vendor ❑ Yes ❑ No ❑ If Yes, Approved by Purchasing <br />MBE/WBE Contractor ❑ MBE ❑ WBE <br />MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company <br />Project Name Greenleaf Greenhouse Development <br />Project Number DP19-023 <br />Funding Source <br />Account No. <br />Amount N/A <br />Terms of Contract <br />Purpose/Description <br />Amount of ❑ <br />El <br />Redevelopment Commission has approved the agreement. <br />Requesting BPW approval of the same agreement that outlines the <br />conditions for the installation of a private irrigation well for the <br />development <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Required For Change Orders Only <br />I ncrease $ <br />Decrease <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy Original <br />❑ ❑ Kyle Silveus <br />❑ ❑ <br />