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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 07/01/19 <br />Name Department: Code Enforcement <br />Try Skibins <br />BPW Date 07/09/2019 Phone Extension 9325 <br />®/✓9. N �Rd NtlM4MM'I RUNNIfiRVIVI lUe9�iflN,�iLiN MMMIIMMIMIIPIJM'IWW�I'M'I�V�V�W,W,W,HM'M'KKN'VW'MW66 W IfU�➢W dGY 6AYdd <br />,..m. ...... �.�,........, le ww....,.m,,,, �„—,...,n,,...,...... �....,..w ,,,, ....,. <br />....�. � mmmm Required Prior to_Submittal to Board <br />BPW Attorney ❑ Attorney Name <br />Dept. Attorney ® Attorney Name Tom Panowicz <br />Purchasing <br />........ _ _ _.._. _ ......... ...... <br />Check the Appropriate Item TypeRequired Jbr All Submissions <br />LJ Professional Services Agreement ❑ Contract <br />0 <br />Open Market Contract ❑ Amendment/Addendum <br />❑ <br />Bid Opening ® Bid Award <br />❑j <br />Quote Opening Quote Award <br />E] <br />Proposal Opening C/O & PCA No. <br />Chg. Order, No. Traffic Control <br />F-1 Other: <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 />F�.Proposal ........ wm�.._..m.......: <br />Special Purchase, QPA <br />❑ Req. to Advertise ❑ Title Sheet <br />0 Reject Bids/Quotes <br />FI PCA <br />nResolution <br />Ease./Encroach <br />Hamilton <br />Towing <br />YesIf Y. <br />es, Approvedy Purchasing <br />b .�chasing <br />® No <br />❑ MBE Completed E-Verify Form Attached ❑ Yes <br />❑ WBE ❑ No <br />Towin2 Services for the Department of Code Enforcement <br />Removal, towin stork �e and disposal services. <br />... ... <br />For a .8, m9rders Onl <br />Amount of <br />❑ Increase $ <br />❑ Decrease ($ <br />Previous Amount $_ <br />Increase............�.—�..�......................................... ....................m......_..���..............................................._..................................-.. <br />Current Percent of Change: Decrease /o) <br />New Amount $ <br />......Increase .....�m...................._ �..o/o.�........................-.� m,�................�.m..m....�_��.........�......................�.... .......9......... <br />Total Percent of Change: Decrease ( %) <br />Time Extension Amount: <br />New Completion Date: <br />