Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />October 15, 2018 <br />Department <br />Public Works <br />Name <br />Roger Nawrot <br />Division/Bureau <br />Engineering <br />BPW Date <br />October 23, 2018 <br />Phone Extension <br />5932 <br />-Required Prior to Submittal to Board <br />Legal ® Attorney Name: <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 <br />U Agreement Amendment <br />U Contract LJ Proposal U Addendum <br />® Professional Services <br />❑ Resolution <br />❑ Bid Opening <br />❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ <br />Quote Opening <br />❑ Quote Award <br />❑ <br />Change Order No. <br />❑ <br />CIO & PCA No. ❑ PCA <br />❑ Ease/Encroach. <br />❑ <br />Traffic Control: <br />I -I Other: <br />Company or Vendor Name .Jones Petrie Rafinski Corporation <br />❑ Yes ® No ❑ If Yes, Approved by <br />New Vendor Purchasing <br />MBEIWBE Contractor ❑ MBE ❑ WBE <br />MBEANBE Contractor Requested ® No ❑ Yes Name of Company <br />Project Name Michigan Street Reconstruction <br />Project Number 118-075 <br />Funding Source LRSA - Professional Services <br />Account No. 251-0608-431.36-06 <br />Amount $170,000.00 <br />Terms of Contract <br />Purpose/Description <br />Amount of ❑ <br />Increase <br />Decrease <br />Not to Exceed <br />The design for the reconfiguration and full depth pavement <br />replacement of Michigan Street from Western Avenue to Colfax <br />Avenue. Also, streetscape and lighting design between Western <br />Avenue and Wayne Street. <br />❑ Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />R. <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy Original <br />❑ ❑ <br />❑ ❑ <br />❑ ❑ <br />