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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 05/01/2018 Department <br />Name Toy Villa Al Division/Bureau <br />Public Works <br />Engineering <br />BPW Date 05/08/2018 Phone Extension 5920 <br />Legal 0 Attorney Name: <br />Controller El 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 />Ll <br />Agreement Amendment <br />H Contract L] Proposal LJ Addendum <br />n <br />Professional Services <br />F] <br />Resolution <br />n Bid Opening <br />E] <br />Bid Award E] Req. to Advertise El Title Sheet <br />F-1 Quote Opening <br />M <br />Quote Award <br />Z <br />Change Order No. 1 <br />El C/O & PCA No. E] PCA <br />0 <br />Ease/Encroach. <br />❑ Traffic Control: <br />F-1 <br />Other: <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 />Edward J. White, Inc. <br />El Yes M No ❑ If Yes, Approved by <br />Purchasing <br />[_1 MBE El WBE <br />El No F1 Yes Name of Company <br />Century Center Vestibule Heater <br />117-044 <br />Hotel -Motel Tax <br />7304.42010.000,0099 <br />Increase Thermal Overloads and Thermal Scanner <br />F-1 Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verifv, Iran, etc. <br />Amount of Increase $1,945.74 <br />Decrease $ <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Chanqe-. <br />Copy <br />Original <br />F-1 <br />F-1 <br />F-1 <br />F-1 <br />F <br />F <br />$ 32,205.00 <br />6.04% <br />$34,150.74 <br />6.04% <br />