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BOARI) OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 06122/2018 Department Public Works <br />Name Toy Villa Division/Bureau Engineering <br />RPW Date 07/10/2018 Phone Extension 5920 <br />Legal F1 Attorney Name: <br />Controller El Controller review is required for all Contracts $5,000.010 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing El <br />L_] <br />Agreement Amendment " Contract L] Proposal LJ Addendum <br />F-1 <br />Professional Services F] Resolution <br />F] <br />Bid Opening F] Bid Award Ej Req. to Advertise El Title Sheet <br />F-1 <br />Quote Opening Quote Award <br />Z <br />Change Order No. I ❑ C/O & PCA No. E] PCA <br />E] <br />Ease/Encroach, ❑ Traffic Control: <br />F-1 <br />Other: <br />Company or Vendor Name <br />New Vendor <br />MBENVBE 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 />Amount of H <br />El <br />Ram Construction Services of Michigan, Inc. <br />El Yes Z No ElIf Yes, Approved by Purchasing <br />[:] MBE [:] WBE <br />El No El Yes Name of Company <br />Leighton Deck Coatings — Phase 11 <br />117-092 <br />River West TIF <br />3241050,460.42,03 <br />$189,000.00 <br />Added Joint Repairs <br />F-1 Required Contractor's Certification Forms Attached (Non- <br />Collusi:on, Non-Discri rn i nation, Non -Debarment, E-Vedfv, Iran, etc. <br />Increase $ 12,078-00 <br />Decrease $ <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Chance: <br />Copy <br />Original <br />R <br />F-1 <br />F] <br />1-1 <br />E] <br />El <br />