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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />DateSeptember 2, 2020 <br />Department Public <br />NameScott KreegerWorks <br />BPW DateSeptember 8, 2020Phone Extension9245 <br />Required Prior to Submittal to Board <br />BPWAttorneyAttorney Name <br />Dept. AttorneyAttorney Name <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 Control:Resolution <br />Residential Handicap <br />Parking <br />Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name <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 Name1142 E Bissell StResidential Handicap Parking <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description____Original resident who originally applied for the handicap parking signs <br />back in2018 is no longer residing on the property. RecommendApprovalfor <br />the removal of the handicap signs. <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 />Time ExtensionAmount: <br />New Completion Date: <br />