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Date <br />Name <br />BOA1;tD OF PUBLIC WORKS <br />AGENDA ITEM IZEVIEW REQUEST FORM <br />Sue Ellen Doudrick <br />Department <br />Division/Bureau <br />Public Works <br />Engineering <br />BPW Date 10/23/18 Phone Extension 5992 <br />Required Prior to Submittal to Board <br />Legal Z Attorney Name: Clara McDaniels <br />Controller Z 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 R Michael Schmidt <br />M Agreement Amendment <br />H Contract Lj Proposal H Addendum <br />F-1 Professional Services <br />n Resolution <br />n Bid Opening <br />Fl! Bid Award E] Reg, to Advertise 0 Title Sheet <br />n Quote Opening <br />El Quote Award <br />Change Order No. <br />F-1 C/O & PCA No. El P,CA <br />❑ Ease/Encroach. <br />F] Traffic Control: <br />FOther: <br />Company or Vendor Name <br />Srn#h oup JJR <br />El Yes M No If Yes, Approved by <br />New Vendor <br />Purchasing <br />MBE/WBE Contractor <br />..__ <br />[:1 MBE [:1 WB,E <br />MBENVBE Contractor Requested <br />[:] No [:] Yes Name of Company <br />Project Name <br />Seitz Park Reconstruction <br />Project Number <br />117-093 <br />Funding Source <br />Park Bond <br />Account No. <br />429 <br />Amount <br />Terms of Contract <br />$683,500 <br />Purpose/Description <br />Final Design professional services for the Seitz Park, East Race <br />Pedestrian crossing, East Bank Trail, Trail from Seitz to Colfax, <br />and Trail from Seitz to Howard Park <br />El Required Contractor's Certification Forms Attached (Non- <br />CoHusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Required For Change Orders Only <br />Amount of El increase <br />0 Decrease <br />$ <br />$ <br />Previous Amount $ <br />Current Percent of Change: <br />% <br />New Amount $ <br />Total Percent of Change: <br />% <br />Dispersal After Approval <br />Copy Original <br />El F-1 <br />El 1-1 <br />E] El <br />