Traffic Control Device - All Way Stop Condition @ Wayne and St Louis

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date December 17, 2018 Name Roger T. Nawrot Department Public Works Division/Bureau Engineering BPW Date December 20, 2018 Phone Extension 5932 iw��om��oiervrc��uma�a... ��rm�wwrmmaawimumr� uumttmr�rwomiMuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuu � mr��mmmmwumw�mumwu�wmrmo m m�muumu� ..............,,............................._..�.�.........�.._...._._............_�,�, ..._...... E. _Re,uired Prior to Submittal to Board �ITITITITIT ww _ w� Legal ❑ 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 El Check the IJ Agreement EJ Professional Services E] Bid Opening Quote Opening Change Order No. _ �I Ease/Encroach. Other: Company or Vendor Name �roriate Item Ty..: El Contract Resolution for All Submissions I Proposal E] Bid Award ❑', Req. to Advertise Quote Award ❑ C/O & PCA No. EJ PCA ® Traffic Control: New Vendor MBE/WBE Contractor MBE/WBE Contractor Requested Project Name Project Number Funding Source Account No. Amount Required Information _..-0MR, ❑ Title Sheet ❑ ...Yes .�.�®....No................��... ❑ If Yes, Approved b Purchasing MBE L WBE No F1 Yes Name of Com St. Louis Blvd. & Wayne St. All„ Way Stogy 21 Terms of Contract Purpose/Description Changing the intersection of St. Louis Blvd. and Wayne St. to an All -Wad+ Stop condition Required Contractor's Certification Forms Attached Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) ...mm.. -or Chan-- m ...... W.. ......, .. ..-._. . For Orders Only Amount of El Increase $ Decrease $ Previous Amount Current Percent of Change: % New Amount Total Percent of Chance: % Dispersal After Copy Original 0 ❑ El ❑