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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 10/15/2018 Department Public Works <br />Name Toy Villa Division/Bureau Engineering <br />BPW Date 10/23/2018 Phone Extension 5920 <br />Legal F-1 Attorney Name: <br />Controller El 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 0 <br />" Agreement Amendment <br />H Contract LJ Proposal L] Addendum <br />F1 Professional Services <br />F Resolution <br />F-1 Bid Opening <br />El Bid Award Req. to Advertise Z Title Sheet <br />F-1 Quote Opening <br />F1 <br />Quote Award <br />Change Order No. <br />[:] <br />C/O & PCA No. F-1 PCA <br />Ease/Encroach. <br />F1 Traffic Control: <br />Other: I <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />MBEANBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />F1 Yes F] No ❑ If Yes, Approved by <br />Purchasing <br />[:1 MBE [:1 WBE <br />F] No El Yes Name of Com py <br />Fat Daddy's Building Demolition <br />118-066 <br />RWDA (River West Development Area) <br />324.1050.460.39.82 <br />F-1 Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination. Non-Debarmient, E-Vedfv. Iran, etc. <br />F-1 increase $ <br />Amount of <br />El Decrease, <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />roval <br />Copy <br />Kara Boyles, City Engineer <br />David Relos <br />Original <br />M <br />E] <br />H <br />F-1 <br />El <br />1-1 <br />