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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST' FORM <br />Date April 3, 2018 Department Public Works <br />Name <br />Tara Weigand <br />Division/Bureau <br />Engineering <br />BPW Date <br />April 10, 2018 <br />Phone Extension <br />5998 <br />Legal Z 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 ❑ <br />Z <br />Agreement Amendment <br />H Contract H Proposal UI Addendum <br />F� <br />Professional Services <br />❑ <br />Resolution <br />❑ Bid Opening <br />0 <br />Bid Award El Req. to Advertise El Title Sheet <br />❑ Quote Opening <br />❑ <br />Quote Award <br />n <br />Change Order No. <br />❑ C/O & PCA No. ❑ PCA <br />F1 <br />Ease/Encroach. <br />❑ Traffic Control: <br />F] <br />Other: <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />MBEANBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of <br />D <br />Alliance Architects, Inc. <br />❑ Yes M No ❑ If Yes, Approved by <br />Purchasing <br />[J MBE n WBE <br />❑ No Yes Name of Company <br />New Convention Hall Entrance at the Century Center <br />115-017 <br />Hotel -Motel <br />7304,42010.000.0099 <br />$7,250 <br />Lump Sum <br />Amendment to resume project 115-017. This will include <br />completion of construction documents, bidding, and construction <br />administration. <br />[:1 Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Increase $ <br />Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy Original <br />M Patrick Sherman, VPA <br />0 ❑ Scott Herczeg, Century Center <br />❑ ❑ <br />