Laserfiche WebLink
!0z <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Roger Nawrot <br />Department <br />Division/Bureau <br />Engineering <br />BPW Date June 26, 2018 Phone Extension 5932 <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 />a I " 1 0 111 <br />" Agreement <br />H Contract ❑ Proposal " Addendum <br />0 <br />Professional Services <br />F-1 Resolution <br />E] <br />Bid Opening <br />El Bid Award Z Req. to Advertise Z Title Sheet <br />[:1 <br />Quote Opening <br />❑ <br />Quote Award <br />F-1 Change Order No., <br />C/0 & PCA No. ❑ PCA <br />❑ Ease/Encroach. <br />F-1 <br />Traffic Control: <br />Other: <br />Company or Vendor Name <br />New Vendor <br />El Yes El No If Yes, Approved by <br />Purchasina <br />MBENVBE Contractor 2 MBE <br />MBEANBE Contractor Requested F1 No 1 <br />Project Name <br />Project Number <br />Fuinding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of <br />Increase <br />Decrease <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Copy <br />Original <br />EJ <br />1:1 <br />F <br />F-1 <br />El <br />El <br />FOR <br />" WBE <br />I Yes Name of Company <br />Park Redevelopment & St. <br />,nents <br />Louis Boulevard <br />Park Bond, IRETIF, Regional Cities & Cumulative Capital <br />452-1101-452.02&452.03, 429-1050-460.42-02, 201 -11111 - <br />452.42-01, 407­1101-452A201 <br />Not to Exceed <br />The proiect will have bids received on August 23. <br />❑ Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Elizabeth Maradik <br />