Change Order No 2-PCA - Downtown Bridge Striping Project No 117-129 - The Airmarking Co

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 10/23/2018 Department Public Works Name Toy Villa Division/Bureau Engineerin g ��BPW Date 11/13/2018 Phone Extension 5920 u Y ININIMIImmmmIIIIIIIIIIIIIIIIIIIIIIImmmmmllmllN&. . IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIMIYmi .. _ RequiredITPrior to Submwittal to Board Legal ❑ Attorney Name: Controller ❑ Controller review is required for all Contracts $5,000.00 or more and greater than one year in length per the City Purchasing Policy Purchasing ❑ Check the ❑ Agreement Amendment [❑' Professional Services Bid Opening El Quote Opening [� Change Order No. ® Ease/Encroach. Other: General Release Company or Vendor Name lropfpteItem... . ❑ Contract Resolution El Bid Award ® Quote Award ®C/O &PCANo ❑ Traffic Control: New Vendor MBE/WBE Contractor MBE/WBE Contractor Requested Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description kq for All Subm►ss►ons. Proposal ❑ Req. to Advertise 2 Final ❑ PCA The Airmarking Co., Inc. El Yes .........._. No. Purchasi.n,......................................�... ❑ MBE ❑ WBE Yes............N.am.e....of Downtown Bridge Strir)in 117-129 LRSA / Lane Markini 2.5.1. 0608.431..42..93 Proiect Closeout Addendum ❑ Title Sheet If Yes, Approved by s & LRSA / Street Maintenance, & 251.0608.431.36.10 ❑ Required Contractor's Certification Forms Attached (Non - Collusion„ Non -Discrimination„ Non -Debarment, EVerify, Iran, etc. For Champ- Orders ..nll.,.:.....w. . Amount�m .. of ❑ Increase ® Decrease $ 445.05 Previous Amount $ 86,802.20 Current Percent of Change: 0.51 % New Amount $ 86,357.15 Total Percent of Change 19.11 % Discersal After Aodroval Copy Original ® ❑I Sue Ellen Doudrick