Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 12/04/2018 Department Public Works <br />..w�wW _�.m...........__......... <br />Name Toy Villa Division/Bureau Engineering <br />BPW Date 12/11/2018 Phone Extension 5920 <br />umimnmmn lulu m;.wuu�mwwmwwwomomomomorvmmmm�mwmmwnnmmr�i <br />uired Prior to Submittal to Board <br />LegalEl Attorney Name: <br />Controller ❑ Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing <br />uCheck the <br />LJ Agreement <br />❑ Professional Services <br />❑ Bid Opening <br />❑ Quote Opening <br />❑ Change Order No. <br />(� Ease/Encroach. <br />Other: <br />iropriate Item Type - <br />Contract <br />Resolution <br />El Bid Award <br />Quote Award <br />❑ C/O &PCANo. <br />El Traffic Control: <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />MBE/WBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Copy <br />Original <br />Required Information <br />Walsh „& Kelly, Inc. <br />for All Submissions <br />J Proposal <br />Req. to Advertise <br />. _. __�.�... .. El I If f <br />Yes No Yes, A <br />MBE WBE <br />�.�....._ .. ...._ <br />[� No Yes Name of Company <br />Ironwood Sidewalks <br />.............. <br />117-033A <br />LRSA - Mayor Moves <br />251.0608.431.42.96 ..............Y <br />$ 188,144.74 <br />Proiect Closeout <br />Addendum <br />❑ Title Sheet <br />bar Purchasi <br />❑ Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, mE-Verify, Iran, etc. <br />wired For Change Orders Only .. <br />