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BOARD OF PUBLIC WORKS 1 <br />AGENDA ITEM REVIEW REQUEST FORM COP <br />... _._..... - ..._ <br />Date 3.19. 020 <br />Department <br />Name J�:auuui 1���Ia Xea <br />.._. 1t .` <br />1 <br />BPW Date5 <br />l l Extension 54 <br />Revi �� <br />_. <br />Diversity Comp ew and ,l��,. <br />q al 1 u m to d Prior to Submittal Board <br />��� �� liance <br />�n...,..:�..... <br />and Inclusion Officer Officer Name �� Michael Patton <br />BPW Attorney <br />,d <br />Dept. Attorney�� <br />Purchasing El <br />Attorney Name —,Clara NIllwllanie l <br />Attorney Name sailild a I aalll: <br />Check the Appropriate Item Type , <br />Professional Services Agreement 0 Contract <br />Open Market ContractAmendment/Addendum <br />El Bid Opening E] Bid Award <br />F❑l Quote Opening El Quote Award <br />❑ Proposal Opening ❑ C/O & PCA No. <br />7I Chg. Order, No. ❑ Traffic Control <br />Other: , f kI O U <br />Information <br />Company or Vendor Name Our Uxb 4'f Ithe tic�ad <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 />All Submissions <br />❑ Proposal <br />E] Special Purchase, QPA <br />0 Req. to Advertise <br />El Reject Bids/Quotes <br />n PCA <br />Resolution <br />Ease./Encroach <br />❑ Title Sheel <br />LJ Yes" If Yes, Approved by Purchasing <br />0 No <br />MBE Completed E-Verify Form Attached ❑ Yes <br />WBE ❑ No <br />i:a la�,1 au 1 <br />Increase <br />Amount of For "irte Orders 01 .. <br />_.$. ... ----- ............. _mn.. -- __._.... <br />El Decrease ($ ) <br />Previous Amount $ _ <br />.....Increase..,.........-- .��.........__ <br />Current Percent of Change: Decrease % <br />New Amount $_ <br />Increase............___.. % <br />............. <br />g . .... <br />Total Percent of Change: Decrease <br />