Laserfiche WebLink
Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />05/15/2018 <br />_.Kyle Silveus Department Engineering <br />BPW Date 05/22/2018 Phone Extension 5601 <br />Required Prior to Submittal to Board <br />Legal Z Attorney Name Clara McDaniiels <br />Controller El Controller review is required for all Contracts $5,0001.0,0 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing El Michael Schmidt <br />Check the Appropriate Item Type-- Required for Ail Submissions <br />F-1 Agreement M Contract ❑ Proposal ❑ Addendum <br />Professional Services 0 Resolution <br />❑ Bid Opening! El Bid Award El Req. to Advertise D Title Sheet <br />F-1 Quote Opening El Quote Award <br />n Change Order No. ❑ C/O & PCA No. ❑ PCA <br />F-1 Ease/Encroach. Traffic Control <br />F-1 Other: <br />Reauired Information <br />Company or Vendor Name T&D" <br />New Vendor F-1 Yes ❑ No El If Yes, Approved by Purchasing <br />MIBE/WBE Contractor F-1 MBE E] WBE <br />MBENVBE Contractor Requested F-1 No F-1 Yes Name of Company <br />Project Name Pulaski Park Improvements <br />Project Number 118-056 <br />Funding Source TIF Park Bond <br />Account No. 452-1101-452 . 31-06 <br />Amount $90,920.00 <br />Terms of Contract LS <br />Purpose/Description Design Services - Pulaski Park Planning and Improvements <br />[:] Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc. <br />Required For Change Orders Only <br />Amount of F-1 increase $ <br />F Decrease $ <br />Previous Amount $ <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Dispersal After Approval <br />Copy <br />Original <br />F-1 <br />n <br />F] <br />F-1 <br />El <br />0 <br />