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BOARD OF PUBLIC WORI(S <br />AGENDA ITEM REVIEW RE,QUEST FORM <br />Date July 16, 2018 <br />Department Public Works <br />Name Tara Weigand Division/Bureau Engineering <br />BPW Date July 10, 2018 Phone Extension 5998 <br />Required Prior to Submittal to Board <br />Legal E] 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 Michael Schmidt <br />❑ Agreement Amendment <br />F-1 Contract ❑ Proposal Addendum <br />❑ <br />Professional Services <br />F❑I <br />Resolution <br />Bid Opening <br />El <br />Bid Award El Req. to Advertise FTitle Sheet <br />F-1 <br />Quote Opening <br />❑ <br />Quote Award <br />n Change Order No. <br />❑ C/O & PCA No. F] PCA <br />F-1 Ease/Encroach. <br />F-1 Traffic Control: <br />n <br />Other: <br />Company or Vendor Name <br />New Vendor <br />MBEANBE Contractor <br />MBEANBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Brown & Brown General Contractors, Inc. <br />E] Yes M No If Yes, Approved by <br />Purchasing <br />L] MBE F1 WBE <br />El No El Yes Name of Company <br />Bendix Theater Handrails at the Century Center <br />11 8-036A <br />Hotel -Motel <br />7304.42010,000.0099 <br />$12,915.00 <br />Install handrails on the seat risers in Benclix Theater <br />Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Amount of n increase $ <br />El Decrease $ <br />Previous Amount <br />Current Percent of Change: <br />New Amount $ <br />Total Percent of Change: <br />DisDersal After <br />Copy Original <br />F1 Scott Herczeg, Century Center <br />Patrick Sherman, VPA <br />Ed Kowalczyk, Jones Petrie Rafinski <br />