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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 07/19/2018 <br />Department VPA: Facilities & <br />Name Patrick Sherman Grounds <br />BPW Date 07/24/2018 Phone Extension 5601 <br />Ike: oi Dd, Prior to Submittal: to, Board, <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 <br />Z Michael Schmidt <br />H Agreement L] Contract LEI Proposal Addendum <br />F] Professional Services ❑ Resolution <br />El Bid Opening ❑ Bidl Award Req. to Advertise El Title Sheet <br />Quote Opening Z Quote Award <br />❑ Change Order No. El C/O & PCA No. ❑ PCA <br />❑ Ease/Encroach. F-1 Traffic Control <br />F-1 Other: <br />Company or Vendor Name Stone Revival Historical Preservation <br />New Vendor 0 Yes F-1 No Z If Yes, Approved by Purchasing <br />MBENVBE Contractor F] MBE n WBE <br />MBE/VVBE Contractor Requested Z No [J Yes Name of Company <br />Project Name City Cemetery Headstone Repairs <br />Project Number 10,68-2018 <br />Funding Source Facilities and Grounds Maintenance <br />Account No. 201-1101-452,36-09 <br />Amount $165 per repair, $145 per reset <br />Terms of Contract Fixed fee per monument: 67 monuments more or less: <br />Purpose/Description Repair and reset of monuments in CityCemetery. <br />M Required Contractor's Certification Form Attached (Non - <br />Collusion. Non -Discrimination, INon-Debarment, E-Verifv. Iran. etc. <br />Amount of El increase <br />[:J Decrease <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Dispersal After, Approval <br />Copy <br />Original <br />F-1 <br />F-1 <br />F-1 <br />El <br />