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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 1/3/17 <br />Name <br />Aaron Kobb <br />Department <br />Community <br />Investment <br />BPW Date 1/10/17 Phone Extension 5823 <br />Required Prior to Submittal to Board <br />Legal Attorney Name Ben Dougherty <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller ❑ and greater than one year in length per the City Purchasing <br />Policy <br />Purchasing ❑ <br />ZI <br />Agreement <br />❑ Contract <br />❑ Proposal ❑ Addendum <br />❑ <br />Professional Services <br />❑ <br />Bid Opening <br />❑ Bid Award <br />❑ Req. to Advertise ❑ Title Sheet <br />❑ <br />Quote Opening <br />❑ Quote Award <br />❑ <br />Chg Order No. <br />❑ C/O & PCA No. <br />❑ PCA <br />❑ <br />Ease./Encroach. <br />❑ Traffic Control <br />❑ Resolution <br />❑ <br />Other: <br />❑ Claim <br />or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of <br />Crowe Horwath <br />❑ Yes [ <br />❑ No <br />❑ MBE <br />Approved by Purchasing <br />71 WBE Completed E-Verify Form Attached <br />/v ICJ r rD-U <br />Statement of work with Crowe Horwath for River Eas <br />rp oiect f � w ci — 1:.. %t �2 Ay,'-� - ( i ' /�l" j, FL V 7S <br />Increase <br />Decrease <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Time Extension: <br />Copy <br />Original <br />® <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ Yes <br />❑ No <br />$ 50,000 approx. pending funding approval by Redevelopment <br />Commission <br />Aaron Kobb <br />Dispersal After <br />