Change Order No 2 - Berlin Place No 2 Electrical Mechanical and Plumbing Project No 117-048R - CBS Services LLC

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 12/18/2018 Name Toy Villa � Department Division/Bureau Public Works Engineering BPW Date 12/20/2018 Phone Extension 5920 mmm0000000000000000mm iwimmwmwmnmmm wmwwwrni rwmmmmmmmmm� mnv�v r,;arawou: ,,,_.��._.....�......_.... ggwired 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._t._�.. he H Agreement Professional Services Bid Opening Quote Opening ® Change Order No. 2 ❑ Ease/Encroach. Other: p m Type - pro riatem temm�....... El Contract ❑ Resolution El Bid Award El Quote Award R C/O & PCA No. 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 Purpose/Description Amount of Increase nI Decrease Previous Amount $ Current Percent of Change: _ New Amount $ Total Percent of Change: Copy Original for All Submissions Q Proposal ❑ Req. to Advertise uired Information ❑ PCA CBS Services„ LLC Yes N -oo If Yes„ Apra ,.�..... M.B.E . WB E... www NoE] Yes Name of Cow Berlin Place BP#2: Mechanical 117-048P - R RWDA TIF 324.1050.460.31.02 200 Dav Time Extension Purchasi Addendum ❑ Title Sheet Electrical. Plumbin ❑ Required Contractor's Certification Forms Attached (Non - Collusion, Non -Discrimination, Non -Debarment„ EEVerify, Iran, etc. Nuired Form Change Orders Only $ ., . ............. Disrersal After