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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />06/06/2019 <br />Patrick Sherman <br />Department VPA <br />BPW Date 06/11/2019 Phone Extension 5601 <br />NWI�i IY�tll9/lRfl ••Nlflll Mfi IIDIDDIVtdrklb YANIY �.... IN%I��flNiM�'M�'M�'M���W/IllAfi�//0 TWIfN;WIWM <br />Required Prior to Submittal to Bo..._..... <br />and <br />Legal ® 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 />Check the <br />LJ Agreement <br />❑ Professional Services <br />Bid Opening <br />Quote Opening <br />Change Order No. _ <br />[� Ease/Encroach. <br />El Other: <br />Michael Schmidt <br />,ropriate Item TypeRequired for All Submissions <br />Contract Proposal Award <br />El Resolution <br />[J Bid Award ❑ Req. to Advertise <br />Quote Award <br />El C/O & PCA No. ❑ PCA <br />El Traffic Control <br />Required Information <br />Company or Vendor Name Geograoh Industries and Burkhart Si Systems <br />New Vendor ❑ Yes ® No ❑ If Yes, Approved by Purchasing <br />MBE/WBE Contractor ❑ MBE ❑ WBE <br />MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company <br />Project Name VPA Signage and Wayrfinding <br />Project Number 1080-2019 <br />Addendum <br />❑ Title Sheet <br />Funding Source Various: Howard Signaae and Wayfinding from Cum Cap Fund 406 <br />Account No. Various: Howard Signage from 406 1101-452.42 01 <br />Amount $ TBD Based on BPW approved contract <br />Terms of Contract Howard Si na a and wayfinding to Geograph Industries: tries: <br />City Cemetery, West Bank Trail, Leeper Park, Pinhook Park, the <br />Riverwalk, and Pulaski to Burkhart Sign Systems <br />Purpose/Description Development, fabrication and installation of si' na a and wayfinding <br />for Howard and other VPA properties. <br />® Required Contractor's Certification Form Attached (Non- <br />:...... <br />Chan a Orders Only meat, E Verify, Iran, etc_ <br />.ee...eeeee. .. <br />Required For Chcnnation„ on -Debar <br />Amount of Increase $ ... �wwwwwmmm wwmm <br />Decrease $ ........� <br />............................. <br />.�........................ <br />...._._................._ �..._...................................__..__......_ � .�.�.� ..........._�........_ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy Original <br />