Change Order No 1 - Engineering Office Improvements Project No 118-107 - Ziolkowski Construction Inc

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 12/18/2018 Department Public Works Name Toy Villa Division/Bureau Engineering .. ��_._...._...........�......................................... .............. �.�................................. �......��....... �.�....�.�................. BPW Date 12/20/2018 Phone Extension 5920 iM. �mioir.Wmmwmmrc�m�000m�mr�mmiooioioi0000000000000mmmmm wui ,.... xnru�avnnrma� vmmrrrwmimm��wnru�m�rwmm�nme uuw�u�wm^nrrirn i Required Prior to Submittal to Board Legal E] 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 . H Agreement Amendment Professional Services ( Bid Opening Quote Opening ® Change Order No. 1 [� Ease/Encroach. Other: robriate Item Tpb -- " Contract F� Resolution for All Submissions ] Proposal mITIT-m�mmmmmmmITm ❑] Bid Award ❑ Req. to Advertise El Quote Award F] C/O & PCA No. ❑ PCA El Traffic Control: Company or Vendor Name New Vendor MBE/WBE Contractor MBE/WBE Contractor Requested Project Name Project Number Funding Source Account No. Amount Terms of Contract Required Information Ziolkowski Construction„ Inc. Enaineerina Office Improvements 118-107 Professional Servic es . 101.0602.431.31.06 ........... . .................... Addendum ❑ Title Sheet Purpose/Description _ ....E] Required ...Contractor's Certification Forms Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) .. ........ _..... _ ... ........ _ w Required For Chan e�Orders Only _ Amount of ® Increase $ 1, 00 ❑ Decrease $ Previous Amount Current Percent of Change: New Amount Total Percent of Chanute: $ 7,800.00 18.37% 9,233.00 18.37% Dispersal After A Copy Original ® ❑ Kara Boyles ® [❑ Toy Villa El� _ ....... ....... ........