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03/1'3/2018 <br />Toy Villa <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Department <br />Division/Bureau <br />Public Works <br />Engineering <br />BPW Date 03/27/2018 Phone Extension 5920 <br />R�eWire�dPrio�rfo S�Ubmit�taftoBoard <br />Legal U1 Attorney Name. - <br />Controller F-i 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 1-1 <br />LJ Agreement <br />❑ Professional Services <br />❑ Bid Opening <br />F-1 Quote Opening <br />Change Order No. 3 <br />Ease/Encroach. <br />F-1 Other: <br />Company or Vendor Name <br />L Contract <br />F-1 Resolution <br />LJ Bid Award <br />El Quote Award <br />[:1 C/O & PCA No. <br />El Traffic Control: <br />New Vendor <br />MBE/WBE Contractor <br />MBEMBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />E] Req. to Advertise <br />um <br />Addendum <br />El Title Sheet <br />Gibson -Lewis, LLC <br />El Yes 0 No ❑ If Yes, -Approved by <br />Purchasina <br />L-1 MBE LJ WBE <br />F-1 No F-11 Yes Name of ComDanv <br />2016 Parking Garage Improvements <br />115-143 <br />Major Moves <br />412-0401-415-36.01 <br />Amount $ <br />Terms of Contract <br />Purpose/Description Circuitry Update Requirements at Wayne and Leighton Parking <br />-Garages <br />[J Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />�90uir iai1 Oango rdr "Cray <br />Amount of Increase $16,670.00 <br />El Decrease $ <br />Previous Amount $ 1,204,587.00 <br />Current Percent of Change: 1.3 8 _% <br />New Amount $1,221 ,257.00 <br />Total Percent of Change: 6.66% <br />Copy <br />Original <br />F] <br />