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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 12/18/2018 <br />. . . . . . . . . ............ ---------- <br />Name Toy Department Engineering <br />BPW Date 12/20/2018 Phone Extension 5920 <br />mmmmffimn� <br />. . ........ <br />Legal El Attorney Name <br />Controller Controller review is required for all Contracts $5,000.00 or more anc <br />greater than one year in length per the City Purchasing Policy <br />Purchasing E] <br />Check the A <br />LJ Agreement <br />F] Professional Services <br />F] Bid Opening <br />n Quote Opening <br />Z Change Order No. 4 <br />Ease/Encroach, <br />❑ Other: <br />iropriate Item.T. <br />7 <br />Contract <br />Resolution <br />Bid Award <br />El Quote Award <br />F1 C/O & PCA No. <br />0 Traffic Control <br />for All Submissions <br />Proposal ..................... Addendum <br />El Req. to Advertise El Title Sheet <br />uired Information <br />Company or Vendor Name Gibson-Lewis,-ILLC <br />El PCA <br />New Vendor El Yes X No El If Yes, Approved by Purchasing <br />MBE/WBE Contractor F-1 MBE [-] WBE <br />MBE/WBE Contractor Requested [:] No E] Yes Name of Company <br />Project Name Charles Black Center Renovation <br />Project Number 116-073 <br />Funding Source Park Bond <br />- ........................ .. . ........ <br />Account No. 751.1101.452.39.89 <br />Amount <br />Terms of Contract <br />Purpose/Description Addition of Misc. Items and including the Soccer Field irrig� ion <br />F-1 Required Contractor's Certification Form Attached (Non- <br />. . . ........ Non -Discrimination, Non Debarment, E-Verif Iran, etc.) <br />Required For Change Orders Only <br />Amount of increase $51,823.00 <br />�E] Decrease <br />Previous Amount $ 3,921,637.00 <br />Current Percent of Change: 1.320 <br />New Amount _3,_97_3,"46 --- 0-.00 . ....... <br />Total Percent of Change: -4.47% <br />Dispersal After Approval <br />Copy <br />Original <br />F-1 <br />F-1 <br />F1 <br />❑ <br />1-1 <br />El <br />