Laserfiche WebLink
Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW RE, QUEST FORM <br />12/20/2017 <br />Josh Ehmer <br />Department Public Works <br />BPW Date 12/21/2017 Phone Extension 9175 <br />Legal Attorney Name <br />Controller review is required for all Contracts $5,0001.00 or more <br />Controller El and greater than one year in length per the City Purchasing <br />Policy <br />Purchasing F-1 <br />Ll Agreement <br />H Contract LJ Proposal <br />H Addendum <br />F-1 Professional Services <br />El Amendment <br />❑ Bid Opening <br />n Bid Award [J Req. to Advertise, <br />❑ Title Sheet <br />❑ Quote Opening <br />F-1 Quote Award <br />Z Chg Order No. 1 <br />n C/O & PCA No. E] PCA <br />El Ease./Encroach. <br />F-1 Traffic Control n Resolution <br />El Other: <br />El Claim <br />Required, Information <br />Company or Vendor Name <br />Ziolkowski Construction, Inc. <br />New Vendor <br />El Yes If Yes, Approved by Purchasing <br />[:] No <br />MBEANBE Contractor <br />1:1 WBE <br />Completed E-Verify Form Attached F-1 <br />❑Nos <br />Project Name <br />2017,Curb and Sidewalk (Div B,C,D,E, & F) <br />Project Number <br />1117-008 <br />Funding Source <br />MVH <br />Account No. <br />202-0619-431.31-06 <br />Amount <br />$8,0100.00 <br />Terms of Contract <br />Purpose/Description Additional quantities of sidewalk replacement and re -mobilization <br />charge. <br />For Change, Orders Only <br />Amount of Increase $$8,000.00 <br />❑ Decrease $ <br />Previous Amount $ 260,381.00, <br />Current Percent of Change: 3.,07% <br />New Amount <br />Total Percent of Change <br />Time Extension: <br />Copy <br />Original <br />El <br />El <br />3,07% <br />115 <br />Dispersal After Approval <br />