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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 04/07/2020 <br />Name Brian Donoghue Department Innovation & Technology <br />BPW Date 04/14/2020 Phone Extension 7652 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance ® Officer Name Patton <br />and Inclusion Officer <br />BPW Attorney ® Attorney Name McDaniels <br />Dept. Attorney <br />Purchasing <br />® Attorney Name Kennedy <br />Check the Abbrobriate Item TvDe — <br />All Submissions <br />N Professional Services Agreement U Contract U Proposal <br />❑ Open Market Contract ❑ Amendment/Addendum ❑ Special Purchase, QPA <br />❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening ❑ Quote Award ❑ Reject Bids/Quotes <br />❑ Proposal Opening ❑ C/O & PCA No. ❑ PCA <br />❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution <br />n Other: n Ease./Encroach <br />Information <br />Company or Vendor Name <br />Aaron Steiner email: Aaron.j.steiner@gmail.com <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />New Vendor <br />® No <br />Yes <br />MBE <br />MBE/WBE Contractor <br />Completed E-Verify Form Attached <br />❑ ❑ No <br />Project Name <br />Project Number <br />Funding Source <br />Bloomberg Mayors Challenge Award — Gift, Donation, Bequest Fund 217 <br />Account No. <br />217-0674-415-31.06 <br />Amount <br />$ 109,960 <br />Terms of Contract <br />4/14/2020 — 5/5/2021 <br />Purpose/Description <br />Professional Services agreement for management of Bloomberg Mayors <br />Challenge program <br />For Change Orders Only <br />Amount of ❑ <br />Increase $ <br />❑ <br />Decrease ($ ) <br />Previous Amount <br />$ <br />Increase % <br />Current Percent of Change: <br />Decrease ( %) <br />New Amount <br />$ <br />Increase % <br />Total Percent of Change: <br />Decrease ( %) <br />Time Extension Amount: <br />New Combletion Date: <br />