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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />12-18-2018 <br />Brian Donoahue <br />Purchasing <br />Check the <br />[] Agreement <br />Z Professional Services <br />❑ Bid Opening <br />❑ Quote Opening <br />Change Order No. _ <br />n Ease/Encroach. <br />F] Other: <br />Wo riat Item T <br />-- y . <br />Contract <br />FResolution <br />Bid Award <br />❑ Quote Award <br />❑ C/O &PCANo. <br />Traffic Control <br />Department Innovation <br />for All Submissions <br />] Proposal ❑ Addendum <br />❑ Req. to Advertise ❑ Title Sheet <br />Required Information <br />❑ PCA <br />Company or Vendor Name EnFocus <br />New Vendor <br />❑ Yes ® No ❑ If Yes, Approved by Purchasing <br />MBE/WBE Contractor <br />❑ MBE ❑ WBE <br />MBE/WBE Contractor <br />Requested ❑ No ❑ Yes Name of Company <br />Project Name <br />-----_.... ......... �... <br />Project Number <br />Funding Source <br />COIT Fund Professional Services <br />Account No. <br />......................................................._... <br />279-0672-415.31-06 <br />Amount <br />$99,000 <br />Terms of Contract <br />.. ..... ._.....__. <br />12/20/2018 — 12/31/2019 <br />Purpose/Description <br />2018-2019 Consulting Agreement <br />® Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verif , Iran, etc. <br />Re uired For Change Orders Only <br />Amount of ❑ <br />Increase $ ...... <br />... ............ <br />�� <br />Decrease $ <br />Previous Amount <br />$ <br />Current Percent of Change: % <br />New Amount <br />$ �.M....._ <br />. . . ......................... ....... __. �.—._.... <br />Total Percent of Change: % <br />.......... ...—._ <br />Dispersal After Approval <br />Copy Original <br />® ❑ ._ <br />Brian Donoghue <br />......... ...._.... ......... <br />® ❑ <br />Dan O'Connor <br />® ❑ <br />............................ .......... ..... <br />Shawn Delahunty <br />