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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 5/21/18 <br />Name <br />Pam Meyer <br />Department <br />DCI <br />BPW Date <br />. ........ . <br />6/12/18 . ......... <br />Phone Extension <br />5845 <br />Legal Z Attorney Name Clara McDaniels <br />Controller ❑ Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing z <br />F---"- Check the Appropriate Item Type — Required for All Submissions <br />El Agreement n Contract El Proposal El Addendum <br />F-1 Professional Services <br />0 Bid Opening <br />El Quote Opening <br />Fj Change Order No. <br />0 Ease/Encroach. <br />F-1 Other: Amendment <br />2 Resolution <br />E] Bid Award <br />Quote Award <br />■ C/O & PCA No. <br />Traffic Control' <br />El Req. to Advertise <br />NAM <br />Company or Vendor Name Near Northwest Neighborhood, Inc. <br />New Vendor 0 Yes E No 0 If Yes, Approved by Purchasing <br />MBENVBE Contractor E] MBE F1 WBE <br />MBE/WBE Contractor Requested M No n Yes Name of Company <br />Project Name -Real Property Transfer Agreement <br />Project Number N/A <br />Funding Source N/A <br />Account No, N/A <br />Amount $1.00 <br />0 Title Sheet <br />. .............. . ... <br />Terms of Contract Transfer will occur ino later than August 31, 2019 <br />Purpose/Description Transfers property for housing development project, contingen <br />ur)on successful IHCDA tax credit award in November 2018 <br />F] Required Contractor's Certification Form Attached (Non - <br />Collusion. Non -Discrimination. Non -Debarment, E-Verifv. Iran. etc. <br />Amount of F] increase $ <br />El Decrease $ <br />Previous Amount $ <br />Current Percent of Change. <br />New Amount $ <br />Total Percent of Change: <br />Copy Original <br />M E Pam Meye <br />n F-1 <br />n 11 <br />Dispersal After Approval <br />Im <br />