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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date December 1.3 2019 <br />Name .......... -Pamela Meyer ..... . ............. Department DCI <br />BPW Date December 19 2019 Phone Extension 5845 <br />wired Prior to Submittal to Board <br />BPW Attorney F-1 Attorney Name McDaniels <br />Dept. Attorney EJ Attorney Name Kennedy <br />... . ... ... . ... . .... <br />Purchasing F-1 <br />U Professional Services Agreement HContract <br />EJ Open Market Contract <br />E] <br />Amendment/Addendum <br />[J Bid Opening <br />EJ <br />Bid Award <br />Quote Opening <br />El <br />Quote Award <br />Proposal Opening <br />❑ <br />C/O & PCA No. <br />F-1 Chg. Order, No. <br />0 <br />Traffic Control <br />F-1 Other: <br />Company or Vendor Name St. Josep,' <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 />dfiv All Submissions <br />E]Proposal <br />[:] Special Purchase, QPA <br />El Req. to Advertise ❑ Title Sheei <br />E] Reject Bids/Quotes <br />[:] PCA <br />x Resolution <br />Ease./Encroach <br />LJ Yes LJ If Yes, Approved by Purchasing <br />F] No <br />MBE Completed E-Verify ❑ <br />Form Attached E] Yes <br />WBE F-1 No <br />- Resolution to accept property transfer to City fi-om County for vacant <br />properties not sold at tax sale and inte al to City's dqvcloRp1gnLq1Aq§. <br />For Change Orders Only . . ........ . .... <br />Amount of Increase . ..................... . . ......... . <br />El Decrease <br />Previous Amount $ <br />................................ <br />Increase % <br />Current Percent of Change: Decrease ....... %. <br />New Amount $ <br />................. <br />Increase % <br />Total Percent of Change: Decrease ....... — % <br />Time Extension Amount: <br />New Completion Date: <br />................ . . . . . . . . . . . .. .... .. ........................ <br />