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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date October 26, 2018 <br />Department Public Works <br />Name Scott Kreeger Division/Bureau Engineering <br />BPW Date November 13, 2018 Phone Extension 9245 <br />.�.��rxr�,rvrce�aa�rr��reo—.. ��<� i��wm�ry �rsuinwuu�,w�aw�����wrtw�r�r�^ wmmu � ,�rr,:�iw�nm�ro�. .� omomw.wrumurrurmw�mrmmrw�mr�w+:����,�xmmmw.usa <br />�. _....._ - Rere ............ <br />....... m.. _....... <br />d Prior to Submittal to Board <br />m. .. ........ �ss �ior ........ . <br />Legal ® Attorney Name Clara McDaniels <br />Controller ❑ Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing ❑ Michael Schmidt <br />Check_ the <br />A reement Amendme <br />❑ g nt <br />El Professional Services <br />R Bid Opening <br />F-1 Quote Opening <br />Change Order No. <br />Ease/Encroach. <br />FA Other: Bid Reiection <br />Company or Vendor Name <br />)ropnate Item Type — <br />El Contract ...... <br />El Resolution <br />El Bid Award <br />❑ Quote Award <br />(1C/O &PCANo. <br />— <br />0 Traffic Control: <br />New Vendor <br />MBE/WBE Contractor <br />MBE/WBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />forAllSubmissions <br />Proposal <br />El Req. to Advertise <br />uired Information <br />I0 - <br />Addendum <br />❑ Title Sheet <br />Lump <br />Bids came in 50% higher than the architect's estimat <br />e. Bid <br />ICage will be modified and rebid at a later date. <br />Lj Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />�,d For Chance Orders <br />Amount of U Increase <br />E Decrease mm$ <br />Previous Amount $ <br />Current Percent of Change: _............_..._.__ <br />New Amount $ <br />Total Percent of Chance: <br />�_..._� ..._........._ ..... Dispersal After Approval............ <br />Copy Original <br />® ❑ Patrick mSherman, Project Ma Manager ..................... <br />_.......�_...W. 1 .� Hager <br />