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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 02/06/2018 <br />Department VPA: Facilities and <br />Name Patrick Sherman Grounds <br />BPW Date 02/13,/2018 Phone Extension 5601 <br />Regul ad Prior to Submittal to Board <br />Legal ❑ Attorney Name Clara McDaniels <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 Michael Schmidt <br />Agreement <br />❑ Contract El Proposal El Addendum <br />Professional Services <br />❑ Resolution <br />Amendment <br />❑ <br />Bid Opening <br />El Bid Award Req, to Advertise E] Title Sheet <br />EJ <br />Quote Opening <br />F] Quote Award <br />El <br />Change Order No. <br />❑ C/O & PCA No. ❑ PCA <br />F-1 Ease/Encroach. <br />❑ Traffic Control <br />n <br />Other: <br />Company or Vendor Name KIL Architecture and Planning <br />New Vendor El Yes M No 0 If Yes, Approved by Purchasing <br />MBE/ WBE Contractor Fj MBE F] WBE <br />MBE/WBE Contractor Requested F] No E] Yes Name of Company <br />Project Name Erskine Clubhouse Remodel <br />Project Number 1008-2017 <br />Funding Source South Side TIF <br />Account No. 430-1050-460-31.06 <br />Amount Addition of $80,000, to original amount of $18,300 to equal total of <br />$98,300. <br />Terms of Contract Lu <br />Purpose/Description To move into detailed design and construction documents. <br />E] Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non-Debarment,.E-V if , Iran, e!q) <br />R <br />Amount of F-1 increase $ <br />El Decrease $ <br />Previous Amount $ <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Copy Original <br />F-1 El <br />Dispersal After Approval <br />