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Date <br />Name <br />BOARD OF PUBLIC WORI(S <br />AGENDA ITEM REVIEW RE, QUEST FORM <br />October 16, 2018 <br />Kara M. Boyles <br />Department Engineering <br />Division/Bureau DPW <br />BP' Date 10/23/18 Phone Extension 5933 <br />Required Prior to Submittal to Board <br />Legal Attorney Name: C. 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 El <br />Z Professional Services <br />Bid Opening <br />Quote Opening <br />F-1 Change Order No. <br />F-1 Ease/Encroach. <br />N Other: Amendment No <br />Company or Vendor Name <br />IRSTM=1 4 mo <br />" Resolution <br />F1 Bid Award <br />F1 Quote Award <br />❑ C/O & PCA No <br />❑ Traffic Control. <br />MBE[WBE Contractor <br />MBEMBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />F Title Sheet <br />- El PCA <br />Black & Veatch Corporation <br />El Yes E] No E] If Yes, Approved by <br />Purchasing <br />❑ MBE 0 WBE <br />❑ No [:] Yes Name of Company <br />Olive GAG Plant Replacements ands Refurbishments <br />118-024 <br />Engineerinq Prof Services <br />101-0602-431.31-06 <br />$8,840 <br />N/A <br />B&V to provide quality control review for quotes related to the <br />North and South Cleveland Well Fields being designed by <br />internal staff. <br />n Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, iran, etc.) <br />Amount of H Increase $ <br />El Decrease $ <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: % <br />Dispersal After, Approval <br />Copy Original <br />F <br />