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BOAM) OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST' FORM <br />Toy Villa <br />Department <br />Division/Bureau <br />Public Works <br />Engineering <br />BPW Date 9/11/2018 Phone, Extension 5920 <br />Required Prior to Submittal to Board <br />Legal ❑ Attorney Name: Clara McDaniels <br />Controller ❑ Controller review is required for all Contracts $5,000,00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing ❑ Michael' Schmidt <br />" Agreement <br />LJ Contract H Proposal H Addendum <br />El <br />Professional Services <br />n Resolution <br />n <br />Bid Opening <br />n Bid Award El Req. to Advertise El Title Sheet <br />F-1 Quote Opening <br />F-1 Quote Award <br />Z Change Order No. 1 <br />El <br />C/O & PCA No. E] PCA <br />❑ <br />Ease/Encroach. <br />El <br />Traffic Control. - <br />Other: <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />MBEANBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of E increase <br />El Decrease <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Copy <br />Original <br />F-1 <br />F-1 <br />F-1 <br />El <br />R. Yoder Construction. Inc. <br />Hibberd Plaza Improvements <br />117-063R <br />RWDA TIF <br />324-1050-460-42.01 <br />Apioroval' of C.O. #1 <br />F-1 Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verifv, Iran. etc. <br />M U611M I <br />$ 445,076.00 <br />1.53% <br />$ 451,874.54 <br />1.53% <br />