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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 12/18/2018 <br />Name Toy Villa <br />Department Public Works <br />Division/Bureau Engineering <br />BPW Date 12/20/2018 Phone Extension 5920 <br />�nNMMIIIIIIIMMMIIIIIIIIIIIIIIIIIIIIIIIIIIWIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1111111 mwfflml�IV!VIVWWWW MMMMMNIIIIIIINllNililillimmmmmMillillilillilimimilliilillillillilwEiNwmmVw WfO <br />............... <br />......... . .... <br />qll Required Prior to Submittal to Board <br />...... . . ... .. . ............. — ...... . ........ <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 />Check the <br />F-1 Agreement Amendment <br />0 Professional Services <br />E] Bid Opening <br />[:] Quote Opening <br />Z Change Order No. 1 <br />Ease/Encroach, <br />Other: <br />Company or Vendor Name <br />iropriate Itern_Type - <br />F-1 Contract <br />F-1 Resolution <br />F-1 Bid Award <br />n Quote Award <br />El C/O & PCA No. <br />F-1 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 />d for All Submissions <br />................. Proposal <br />El Req. to Advertise <br />uired Information <br />INIM <br />Rieth-,Riley Construction Co., Inc. <br />-. ......... <br />C.O. for additional Divisions A2 & F <br />Addendum <br />El Title Sheet <br />F-1 Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination i nation, Non -Debarment, E7Veri!y Iran„ etc. <br />_._Vieqyired For_qharlqq Orders_On1 <br />................... <br />Amount of Increase $87,550.02 <br />E] Decrease <br />Previous Amount 574,345.97 <br />........... <br />Current Percent of Change: 15.24% <br />New Amount 661,895.99 <br />Total Percent of Change: 15.24% <br />Dispersal After Aooroval <br />Copy <br />Original <br />