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Date <br />Name <br />9/18/18 <br />Kyle Silveus <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Department <br />Division/Bureau <br />Public Works <br />Engineering <br />❑ Agreement <br />® Contract ❑ Proposal ❑ Addendum <br />❑ Professional Services <br />❑ Resolution <br />❑ Bid Opening <br />❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening <br />❑ <br />Quote Award <br />❑ Change Order No. <br />❑ <br />CIO & PCA No. ❑ PCA <br />❑ Ease/Encroach. <br />❑ Traffic Control: <br />[-I Other: <br />Company or Vendor Name <br />New Vendor <br />MBEIWBE Contractor <br />MBEIWBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />American Structurepoint, Inc. <br />❑ Yes ® No ❑ If Yes, Approved by Purchasing <br />❑ MBE ❑ WBE <br />❑ No ❑ Yes Name of Company <br />Safe Routes to School near LaSalle Intermediate and Marquette <br />Primary <br />ENG: 116-040 DES No: 1600076 <br />LOIT Major Projects <br />257.0608.431,42.96 <br />$165,126.72 <br />(80%) Federal- (20%) Local <br />Construction Inspection Services for a SRTS project - pedestrian <br />facilities for the LaSalle Intermediate Academy and the <br />Marquette Primary Montessori <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy <br />Original <br />® <br />❑ Kyle Silveus <br />® <br />❑ Caitlin Stevens, MACOG <br />❑ <br />❑ <br />