Change Order No 2-PCA - Marriott Hotel Site Development at Hall of Fam Phase 3 Divisions A&B Project No 117-064 - Walsh & Kelly

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 01/15/2019 Department Public Works Name Toy Vil Division/Bureau Engineering BPW Date 01/22/2019 Phone Extension 5920 Required Prior to Submittal to Board .................... Legal ❑ Attorney Name: Controller El 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 LJ Agreement Professional Services Bid Opening 0 Quote Opening Change Order No. Ease/Encroach. Other: iropriate Item Type - ReCL Contract ❑ Resolution Bid Award F-1 Quote Award M C/O & PCA No. 2(Final) El Traffic Control: Company or Vendor Name New Vendor MBEIWBE Contractor MBE[WBE Contractor Requested Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description for All Submissions Proposal E:1 Req. to Advertise Required Information El PCA Addendum El Title Sheet Walsh & Kelly,.,,Inc. llyes [ ] No ❑ If Yes, Approved by Purchasing, " - ....... MBE R WBE ❑mmNo Yes Name of Com Marriott Hotel Site Development at Hall of Fame Phase 3 117-064 RWDA TIF 324.1050.460.42.03 - Division A & B Protect Closeout F-1 Required Contractor's Certification Forms Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-yeri[y, Iran, etc. . ... ................... __Required For Change Orders Ong . .. . ...... . . . .......... Amount of F1 increase $ ......... Z Decrease $12,007.82 Previous Amount �23 -8' ... 3- _8.'4__ -6 . ......... . . Current Percent of Change: 5.14% J . ....... .... J . . .... New Amount $ 221,830.64 Total Percent of2.79% �_'A—"",-_,___" Dispersal After Arrrova1 Copy Original F-1 E]