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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date May 3, 2919 <br />Name Scott <br />Department Public <br />Works <br />BPW Date Mewa� .aXL�, 2019 Phone Extension 9245 <br />19 �... . .. <br />E Rqqpired Prior to Submittal to Board <br />BPW Attorney E] Attorney Name <br />Dept. Attorney Attorney Name <br />Purchasing <br />Check the Appropriate Item Type - <br />LJ Professional Services Agreement E] Contract <br />E] Open Market Contract <br />El Amendment/Addendum <br />F-1 Bid Opening <br />❑ Bid Award <br />E] Quote Opening <br />Quote Award <br />F-1 Proposal Opening <br />F-1 C/O & PCA No. <br />E]; Chg. Order, No. <br />E Traffic Control: <br />Residential liquidicap <br />Parking <br />LI_Other:--- <br />.......... <br />Company 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 />Information <br />All Submissions <br />--------- - - <br />" Proposal <br />EJ Special Purchase, QPA <br />❑ Req. to Advertise <br />Reject Bids/Quotes <br />PCA <br />❑ Resolution <br />Ease./Encroach <br />El Title Sheet <br />....Yes.... .......❑. .. ......... — - - — ----------- . . . . . .................... . - <br />[:] If Yes, Approved by Purchasing <br />F-1 No <br />❑ MBE Completed E-Verify Form Attached Yes <br />❑ WBE F] No <br />1134 O'Brien Street Residential Handicap Parkin <br />Recommend Denial. Garage. <br />_access available from the alleyway with ar <br />acceptable approach to the back of the House. <br />. . ..... . .......... <br />...... ....... . ....... - <br />For ..Ch.a!1g Orders O ly ........... <br />Amount of <br />El <br />increase <br />1:1 <br />Decrease <br />Previous Amount <br />$ <br />Increase <br />% <br />Current Percent of Change: <br />Decrease <br />� <br />New Amount <br />—0/0 . ...... . . . ..... — <br />Increase <br />% <br />Total Percent of Change: <br />Decrease <br />Time Extension Amount: <br />mmmmm%) <br />New Completion Date: <br />