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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />December 5, 2017 <br />Tara Weigand' <br />Department <br />Division/Bureau <br />Public'' arks <br />Engineering <br />BPW Date December 12, 2017 Phone Extension 5998 <br />Legal M Attorney Name: <br />Controller El Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing Michael Schmidt <br />H Agreement Amendment <br />HI Contract L] Proposal LJ Addendum <br />F-1 Professional Services <br />[] Resolution <br />F-11 i <br />Bid Opening <br />I <br />F]; Bid Award 0 Req. to Advertise ❑ Title Sheet <br />F-1 Quote Opening <br />H Quote Award <br />[:] Change Order No. <br />F-1 C/O & PCA No. 0 PCA <br />F-1 Ease/Encroach. <br />F-1 Traffic Control: <br />0 <br />Company or Vendor Name <br />C & E Excavating, Inc. <br />El Yes 0 No El If Yes, Approved by <br />New Vendor <br />Purchasing <br />MBE/WBE Contractor <br />[:] MBE [J WBE <br />MBE/WBE Contractor Requested <br />[:FNo 0 Yes Name of Company <br />Project Name <br />York Road Sewer Repairs <br />Project Number <br />115-139R <br />Funding Source <br />LRSA CapitaI Major Projects <br />Account No. <br />251-0608-431.42-96 <br />Amount <br />$63,388.50 <br />Terms of Contract <br />Completion Date April 27'r 2018 <br />Purpose/Description <br />Replace damaged pipe behind Fire Station 10 and repair inlet in <br />Crescent Oaks Subdivision. <br />[:] Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran,, etc.) <br />Amount of El increase $ <br />El Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />Copy <br />Original <br />Kara Boyles, City Engineer <br />F-1 Roger Nawrot, Assistant City Engineer <br />F Ron O'Connor <br />