Laserfiche WebLink
Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />08/15/2018 <br />Alicia Czarnecki <br />Department Engineering <br />❑ <br />Agreement <br />❑ Contract ❑ Proposal Lj Addendum <br />❑ <br />Professional Services <br />❑ Resolution <br />❑ Bid Opening <br />❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening <br />® Quote Award <br />❑ <br />Change Order No. <br />❑ C/O & PCA No. ❑ PCA <br />❑ <br />Ease/Encroach. <br />❑ Traffic Control <br />F] <br />Other: <br />Company or Vendor Name <br />Martell Electric, LLC <br />New Vendor ❑ Yes ❑ No ❑ If Yes, Approved by Purchasing <br />MBE/WBE Contractor ❑ MBE ❑ WBE <br />MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company <br />Project Name _Angela Bridge Lighting <br />Project Number 116-111 <br />Funding Source COIT <br />Account No. 404-0602-431.31-06 <br />Amount $49,022.00 <br />Terms of Contract <br />Purpose/Description Provide and install Iights on the Angela Bridge <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion. Non -Discrimination. Non -Debarment, E-Verifv. Iran, etc. <br />Amount of 0 Increase <br />Decrease <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy Original <br />® ❑ Kara Boyles <br />® ❑ Alicia Czarnecki <br />❑ ❑ <br />