Change Order No 4 - Erskine Clubhouse Renovation Project No 116-108 - Ziolkowski Construction

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date Name 12/17/2018 Kvle Silveus Department En �neerin BPW Date 12/20/2018 Phone Extension 9083 wummr�r�m�ura�rarrer�nnN � muuuuuuuumuuuuuuuuuuuuuuumuuuuuuwu �r�mu��tmmm � � rnr muiuiuimi�wmmmuuv�u�.uimuimu ��w�wuwwa squired Prior to Submittal to Legal Attorney Name Clara McDaniels Controller ❑ Controller review is required for all Contracts $5,000.00 or more anc greater than one year in length per the City Purchasing Policy Purchasing Michael Schmidt Check the Agreement Professional Services ❑ Bid Opening ❑ Quote Opening ® Change Order No. 4 ❑ Ease/Encroach. Other: 0 Contract ❑ Resolution Bid Award Quote Award ❑ C/O &PCANo. _ ❑ Traffic Control for All Submissions _................. __........ _.. 9 Proposal El Addendum ❑ Req. to Advertise ❑ Title Sheet uired Information ❑ PCA Company or Vendor Name Ziolkowski Construction Inc. New Vendor ❑ Yes Z No ❑ If Yes, Approved by Purchasing MBE/WBE Contractor ❑ MBE FI WBE MBE/WBE Contractor Requested ❑ No [:] Yes Name of Company Project Name Erskine Clubhouse Renovation Project Number OF, 6-108 Funding Source VPA Maintenance Fund Account No. 201.1101.452 39.89 Amount�...$-15,400.�.................................�__....�................................................... ..�..��.m......�__�....... �......�........�.�.. Terms of Contract Purpose/Description ❑ Required Contractor's Certification Form Attached (Non - Collusion, Non -Discrimination„ Non -Debarment, E-Verify, Iran, etc. Required For Cha nqe Orders Only Amount of ® increase $ Decrease $ 15,400 Previous Amount $ 925„370 Current Percent of Change:-1.66% New Amount $ 909,970.00 Total Percent of Change: 0.33% Dispersal After Approval Copy Original ® ❑ Kyle Silveus ® � Patrick S..................��..��.�.�.�.�...........................m.. .�,� herman