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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date /22/2020 <br />Department <br />Name �muu�u ' ur�d6..1"flruufli^rruii" i:t:mrt:�ru���m,rt <br />BPW Date 4/28 02011 Phone Extension 7/Pt"r'/ <br />�� � mnmmmmmntllaD�. <br />Review and Approval Required Prior to Submittal to Board <br />M,ari.__ _.. __...._.......... <br />Diversity Compliance ❑ Officer Name <br />d Inclusion Officer <br />BPW Attorney ' Attorney Name t:alara l ]k®I)an ielllr <br />Dept. Attorney ❑ Attorney Name <br />Purchasing g m Iic I�Mrel ��c)��wnidt <br />Check the Appropriate Item T ae P r�r a.�l�w�F�l n- All Submissions <br />EJ ❑ p ❑ <br />,E Proposal <br />Professional Services Agreement Contract ❑Pr <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 />n Chg. Order, No. Traffic Control ❑ Resolution <br />(1 Other: n Ease./Encroach <br />Company or Vendor Name ScalIa,tcir I�n_.�.._ _...�........�... ...._��..... <br />New Vendor ❑ Yes If Yes, Approved by Purchasing <br />No <br />MBE/WBE Contractor F� MBE Completed E-Verify Form Attached ❑ Nos <br />Project Name � 020 Street .rM.u�.�~,vseafiu <br />Project Number <br />...................... <br />Funding Source 1. 1J i t J'Z'estr�ctcd , <br />Account No. :/66 0607 43 i 23 ��`/.. _....... <br />Amount s� iru�at:r "�;.�7,800b (Al <br />Terms _... ..__...... <br />Terms of Contract <br />Purpose/Description _ umt: Str c t De art i /ar�.u� <br />fi-ora ScalI d .tr,u tm➢l rtalt a�z/uar; � u r�.�.t.�:..t�u� ....... � acl-u��. �tr1;t <br />,t/gpDn ntat no cost 61 th(11 C .uuIIum (m <br />For Change, Orders Onl <br />Amount of ❑ Increase $ <br />Decrease ($ ) <br />Previous Amount $ <br />.... _............... <br />Increase % <br />Current Percent of Change: Decrease ( % <br />New Amount $ <br />