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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 12/03/2018 <br />Name Toy Villa <br />Department <br />Division/Bureau <br />Public Works <br />Engineering <br />BPW Date 12/11/18 Phone Extension 5920 <br />nv -.. ua�mrm e�mr�uv uawu rr, mmimimmommmffim nm�rm�rmw� wwrcm.�w�m <br />............. ._.mm.m..._ ....... ._._._....._�,�,..._�. <br />Rqq red Prior to Submittal to Board — <br />Legal <br />.�.....� Attorney Name: �.._.. _..� ..............�����.._ww�. <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 />...... __....... . ...................... <br />� <br />m Check the Appropriate Item Type — Require Contract Prop saAll bmissions ❑ Addendu <br />Agree � Resolution <br />m <br />Agreement Amendment <br />Professional Services <br />Bid Opening Lq Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />[� Quote Opening El Quote Award <br />E] Change Order No. ❑ C/O & PCA No. ❑ PCA <br />❑ Ease/Encroach. ❑ Traffic Control: <br />Other: <br />._._.,,,,,. ........ <br />Required Information <br />ompany or Vendor Name <br />R & R Excavatig , Inc,. <br />m....m, AA............[�.�.� <br />New Vendor <br />esNo Y�..E I......_..._....... <br />f Yes <br />MBE/WBE Contractor <br />m.. ,� — <br />MBE <br />uested <br />MBE/WBE Contractor Re...�...................�...._....................!,. <br />q <br />o ❑I Yes Name of Com an <br />...............W.........E <br />Project Name <br />Fat Daddy's.........._....................................._�..........n <br />Project Number <br />118-066 <br />Funding Source <br />RWDA TIF <br />Account No. <br />3.�...�.�_...._......�..._..........................�.�..............................,.�_... <br />24.1050.460.39.82 <br />Amount <br />$540,000.00 <br />Terms of Contract <br />........... ��������....,,_A.................. .......................�......_..........._...... <br />Purpose/Description <br />Award Base Bid plus Alternates 1 <br />