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BOARD OF PUBLIC WORKS <br />AGENDA ITEM RE' VIEW REQUEST FORM <br />Date 914/2018 Department Public Works <br />Name Toy Villa Division/Bureau Engineering <br />BP W Date 9/11/2018 Phone Extension 5920 <br />RequiredPrior to Submittal to Board <br />Legal ❑ 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 n <br />F-1 Agreement <br />H Contract H Proposal L] Addendum <br />El Professional Services <br />El Resolution <br />❑ Bid Opening <br />n Bid Award [ ] Req. to Advertise F-1 Title Sheet <br />Quote Opening <br />F-1 Quote Award <br />Change Order No. 1 <br />❑ C/O & PCA No. PCA <br />Ease/Encroach. <br />❑ Traffic Control: <br />F-11 Other: <br />Company or Vendor Name Rieth,-Riley Construction Co., Inc. <br />0 Yes 0 No F-1 If Yes:, Approved by <br />New Vendor Purchasing <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 />A NITA E VIN, IN <br />[_J No LJ Yes Name of Company <br />Colfax Avenue Two -Way Conversion <br />11 5-053A <br />West Washington Development Area TIF <br />422.1050.460A2.03 <br />$546,703.93 <br />roval 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 />Amount of M Increase $6,500.00 <br />F] Decrease $ <br />Previous Amount $ 546,703.93 <br />Current Percent of Change: 1.19% <br />New Amount $ 553,20,3.913 <br />Total Percent of Change: 1.19% <br />Copy <br />Original <br />❑ <br />F-1 <br />F-1 <br />1:1 <br />1:1 <br />El <br />