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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />August 28, 2018 <br />le Silveus <br />Department Engineering <br />BPW Date Se ternber 11, 2018 Phone Extension 9083 <br />Re aired Prior to l u mi. a to Board <br />Legal ® Attorney Name Clara McDaniels <br />Controller ❑ 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 ❑ <br />U Agreement <br />H Contract LJ Proposal LJ Addendum <br />® <br />Professional Services <br />❑ <br />Resolution <br />❑ <br />Bid Opening <br />❑ <br />Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening <br />❑ Quote Award <br />❑ Change Order No. <br />❑ CIO & PCA No. ❑ PCA <br />❑ <br />Ease/Encroach. <br />❑ Traffic Control <br />n <br />Other: <br />Company or Vendor Name <br />Kil Architecture & Planning <br />New Vendor ❑ Yes ❑ No ❑ If Yes, Approved by Purchasing <br />MBEIWBE Contractor ❑ MBE ❑ WBE <br />Project Name Lafayette Building Skylight & Masonry Repairs <br />Project Number 117-100 <br />Funding Source RWDA <br />Account No. 324-1050-460-31-02 <br />Amount $ 6,000 <br />Terms of Contract <br />Purpose/Description Increase original proposal scope to provide structural engineering services <br />to study the integrity of the existing roof/ curbing for a new skylight. <br />Increase of $6,000 from the original approved PSA value of $32,700 <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion. Non -Discrimination. Non -Debarment, E-Verifv. Iran. etc.) <br />Amount of ❑ Increase <br />❑ Decrease <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Copy <br />Original <br />® <br />❑ <br />David Relos <br />Judy Love <br />Kyle Svlveus <br />Dispersal After Approval <br />