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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 11/5/20 <br />Department <br />Name Kim Thompson Utilities <br />BPW Date 11/12/20 Phone Extension 5969 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance ❑ Officer Name <br />and Inclusion Officer <br />BPW Attorney ElAttorney Name Clara McDaniels <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ❑ <br />Check the Appropriate <br />Item Type — Re wired or All Submissions <br />❑ Professional Services Agreement <br />❑ Contract <br />❑ Proposal <br />❑ Open Market Contract <br />ED Amendment/Addendum <br />❑ Special Purchase, QPA <br />❑ Bid Opening <br />❑ Bid Award <br />❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening <br />❑ Quote Award <br />❑ Reject Bids/Quotes <br />❑ Proposal Opening <br />❑ C/O & PCA No. _ <br />❑ PCA <br />❑ Chg. Order, No. <br />❑ Traffic Control <br />❑ Resolution <br />n Other: <br />n Ease./Encroach <br />Company or Vendor Name <br />Systems & Software <br />❑ Yes❑ If Yes, Approved by Purchasing <br />New Vendor <br />❑ No <br />MBE/WBE Contractor <br />❑ MBE Completed E-Verify Form Attached ❑ No <br />Project Name <br />En uesta CIS Implementation - <br />Formatted: Font color: Text 1, Text Outline, Shadow <br />Project Number <br />NA <br />Formatted: Font color: Text 1, Text Outline, Shadow <br />Funding Source <br />N/A <br />Formatted: Font color: Text 1, Text Outline, Shadow <br />Account No. <br />Formatted: Font color: Text 1, Text Outline, Shadow <br />Amount <br />Formatted: Font color: Text 1, Text Outline, Shadow <br />Terms of Contract <br />- <br />Formatted: Font color: Text 1, Text Outline, Shadow <br />Purpose/Description <br />_Amend the project timeline to delay "eo-live" to December 15, - <br />Formatted: Font color: Text 1, Text Outline, Shadow <br />2020 <br />For Change Orders Only <br />Amount of ❑ <br />Increase $ <br />❑ <br />Decrease ($ ) <br />Previous Amount <br />$ <br />Increase % <br />Current Percent of Change: <br />Decrease ( %) <br />New Amount <br />$ <br />Increase % <br />Total Percent of Change: <br />Decrease ( %) <br />