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BOARD OF PUBLIC WOIU-C.S <br />AGENDA ITEM REVIEW REQUEST FORM <br />12/06/17 Department <br />Toy Villa Division/Bureau <br />12/tO/17 <br />Phone Extension <br />Public Works <br />IMO <br />Legal ❑ Attorney Name-, <br />Controller 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 <br />H Agreement <br />F1 Professional Services <br />F-1 Bid Opening <br />E] Quote Opening <br />F] Change Order No. <br />n Ease,/Encroach. <br />F-1 Other: <br />LJ Contract <br />F] Resolution <br />El Bid Award <br />El Quote Award <br />C/O & PCA No.2 (Final) <br />Traffic Control: <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />MBE/WBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Ritschard Bros_ Inc. <br />Proposal <br />El Req. to Advertise <br />0 <br />lim <br />2017 Demolitions, Phase 1, Divisions A & C <br />117-065 (17J018) <br />RWDA TIF <br />324.1050.460.39,82 <br />Project Closeout <br />F Title Sheet <br />LJ Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />RequjrDd For Change Orders Only <br />Amount of ❑ increase $ <br />M Decrease $ 1,680.00 <br />Previous Amount $76,769.00 <br />Current Percent of Change: 2.19% <br />New Amount $75,089.00 <br />Total Percent of Change: 26.43% <br />Copy <br />Original <br />F] <br />F-1 <br />n <br />El <br />