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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 9.28.2020 <br />Name Pain 'Layer Department DCI <br />BPW Date October 13 2020 Phone Extension 5845 <br />Review and_AP rwmwm_e� - <br />7 ALA Prior t . _._ . 1 to Board <br />�r ... _� �.......... ._ vY��.�._.m�. ......_. .. ov�� Luc uuretl Pnor to Submittal ............._..... ��..�. <br />Diversity Compliance ❑ Officer Name <br />and Inclusion Officer <br />BPW Attorney "` Attorney Name Clara McDaniels <br />Dept. Attorney E Attorney Name Sandra Kennedy <br />_____-- <br />Purchasing ❑ <br />Check the Appropriate Item Type ­ <br />LJ <br />Professional Services Agreement ❑ Contract <br />(❑ <br />Open Market Contract ® Amendment/Addendum <br />Bid Opening ❑ Bid Award <br />❑ <br />Quote Opening ❑ Quote Award <br />❑] <br />Proposal Opening I C/O & PCA No. <br />Chg. Order, No. ❑ Traffic Control <br />Other Access_;Lreen�ent <br />RNuired Information <br />A11 Submissions <br />IL_I Proposal <br />Special Purchase, QPA <br />Req. to Advertise ❑ Title Sheei <br />Reject Bids/Quotes <br />PCA <br />Resolution <br />Ease./Encroach <br />Company or Vendor Name Res ........ Hope____ _ w.. — .. .... <br />New Vendor ❑ Yes If Yes, Approved by Purchasing <br />® No <br />MBE/WBE Contractor Yes <br />❑❑ WBE Completed E-Verify Form Attached ❑ No <br />Project Name Temporary Access Agreement <br />.............. _........... __.. ­ ............. . �. <br />Project Number <br />......... ----- ____ ....... ..._..- ...... .. ...... .- ------- - <br />Funding Source N/A <br />. n.. __........� <br />Account No. N/A <br />- .,......m.. ........... ---- - _...... __ .......... <br />Amount N/A <br />..... - -- <br />Terms of Contract October 1, 2020 generally April 30, 2020 <br />Purpose/Description _-To allo ............at �..... .........._-- <br />w the additional use of certain indoor portions at 510 S. Main Stre <br />for the provision of daily meals <br />y_. <br />For C ai g�,� Orders <br />nl <br />...._... <br />Amount of <br />Increase $ _ <br />Decrease $ ) <br />Previous Amount <br />............... <br />$ ....... __. .......... <br />....... .............................................................................. -- - ----- <br />Increase <br />.......... ...... ....... __.... — ._ ._..n ....... <br />Current Percent of Change: <br />Decrease <br />New Amount <br />$ _.m_.,.m.... <br />m .............. <br />Increase <br />_..__.. <br />% <br />Total Percent of Change: <br />�..�.......m�...... <br />Decrease ( <br />._..- --._m ._.,_., .. <br />/o) <br />Time Extension Amount: <br />New Completion Date: <br />...... ............. ....... <br />