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BOARD OF PUBLIC WOR1,CS <br />AGENDA ITS RE VIEW RE, 'QUEST FORM <br />Date 05/15/2018 <br />Name Patrick Sherman/Alicia Czarnecki Department Engineering <br />BPW Date 05/22/2018 Phone Extension <br />Required Prior to Submittal to Board <br />Legal Z Attorney Name Clara McDaniels <br />Controller z 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 />Check the Appropriate Item Type — Required forAll Submissions <br />[:1 Agreement F-1 Contract El Proposal ❑ Addendum <br />F-1 Professional Services F-1 Resolution <br />0 Bid Opening El Bid Award Req. to Advertise ❑ Title Sheet <br />F-1 Quote Opening F-1 Quote Award <br />F-1 Change Order No. F-1 C/O & PCA No. F-1 PCA <br />F] Ease/Encroach. ❑ Traffic Control <br />F-1 Other: <br />red Information <br />Company or Vendor Name TBID <br />New Vendor El YesEl No E] If Yes, Approved by Purchasing <br />MBE/BE Contractor ❑ MBE F WBE <br />MBENVBE Contractor Requested [:1 No F Yes Name of Company <br />Project Name VPA Maintenance Storage Building <br />Project Number 1062-21018 <br />Funding Source Park Bond Series I <br />Account No. 471-1138-452.42-01 <br />Amount $ TBD <br />Terms of Contract Lump sum base bid with alternates <br />Purpose/Description Storage building extension at Maintenance Division Campus <br />M Required Contractor's Certification Dorm 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 />El Decrease $ Ad?1%W <br />Previous Amount $ <br />Current Percent of Change: % MOM <br />New Amount $ MAY � e) 2 n i iix <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy <br />Original <br />F-1 <br />F-1 <br />F-1 <br />F-1 <br />El <br />R <br />