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BOARD OF PUBLIC WORKS <br />AGENDA ITEM RE, VIEW REQUEST FORM <br />Date <br />Name <br />February 5, 2018 <br />Department Legal <br />BPW Date February 13, 2018 Phone Extension 5866 <br />R,,equi,req,"Prior ,to,'Submittal to Board <br />Legal Attorney Name Clara McDaniels <br />Controller review is requiired for all Contracts $5,000.00 or more <br />Controller El and greater than one year in length per the City Purchasing <br />Policy <br />Purchasing F-1 <br />N Agreement <br />F-1 Professional Services <br />❑ Bid Opening <br />F-1 Quote Opening <br />E] Chg Order No. <br />EJ Ease./Encroach. <br />F-1 Other: <br />Company or Vendor Name, <br />New Vendor <br />MBENVBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />❑I Contract <br />E] Proposal L] Addendum <br />E] Amendment <br />EJ Bid Award <br />E] Req. to Advertise Title Sheet, <br />El Quote Award <br />F] C/O & PCA No. <br />F] PCA <br />n Traffic Control <br />E] Resolution <br />7 Claim <br />El Yes El If Yes, Approved by Purchasing <br />F-1 No <br />MBE Completed E-Verify Form Attached El Yes <br />❑ WBE 0 No <br />Nlon-monetary {i.e., cooperate with Century Center Board in <br />affirmatively attracting convention and other business <br />opportunities). <br />No set termination, date — cessation of Southhold's operation of <br />the Courtyard by Marriott Hotel, forces majeure or inability to <br />continue providing parking priviledge. <br />Authorizes no more than 30 Southhold, employees to -park in City <br />na lot aGowe4he-streef44q+i-the , Centu <br />Far have Only <br />Amount of F-1 increase <br />R Decrease <br />Previous Amount $ <br />Current Percent of Change: _- % <br />New Amount $ <br />Total Percent of Change: % — <br />Time Extension. Dispersal After Approval <br />Copy Original <br />