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130ARD OF PUBLIC WORKS <br />AGENDA ITEM IZE VIEW 1*,QUEST FORM <br />Date <br />09/27/2018 <br />Department <br />Public Works <br />Name <br />Toy Villa <br />Division/Bureau <br />Engineering <br />BPW Date <br />1110/09/2018 <br />Phone Extension <br />5920 <br />Legal: El Attorney Name: <br />Controller E] 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 1:1 <br />LJ Agreement Amendment <br />El Professional Services <br />F-1 Bid Opening <br />❑ Quote Opening <br />Change Order No. 1 <br />❑ Ease/Encroach. <br />Other: General Release <br />Company or Vendor Name <br />H Contract <br />El Resolution <br />n Bid Award <br />F-1 Quote Award <br />n C/O & PCA No <br />F-1 Traffic Control: <br />New Vendor <br />MBEANBE Contractor <br />MBE/WBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Williams Creek Man <br />El Yes [I No <br />Purchasina <br />L Proposal <br />El Req. to Advertise <br />PCA <br />t Corporation <br />Ll MBE Ll WBE <br />F] No n Yes Name of Comr)anv <br />Ravina Park — Bank Stabilization <br />117-07 3A <br />Special LOIT — Major Projects <br />25,7,0608,431.42.96 <br />R61, <br />- 1 6 <br />T rAT qT"T ,T,0M11 <br />El Title Sheet <br />Terms of Contract <br />Purpose/Description <br />F-1 Required Gontractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />. . .... R�,uire�dFqr Change, Orders Only <br />Amount of F-1 increase $ <br />M Decrease $26,810.80 <br />Previous Amount $ 271,710.20 <br />Current Percent of Change: 9.87% <br />New Amount $ 244,899.20 <br />Total Percent of Change: 9.87% <br />Dispersal After Approval <br />Copy Original <br />0 E] Kara Boyles, City Engineer <br />M F-1 Alicia Czarnecki <br />El El <br />