Request to Advertise - Mishawaka Ave Traffic Signals at Fire Station No 9 Project No 117-120A

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date January 14, 2019 Name Roger Nawrot Department Public Works Division/Bureau Engineering BPW Date January 22, 2019 Phone Extension 5932 uuuuuuumo uuuummwwmwwuumimmm mmm� ME H05555555mmmm0mi M1 vmmrr m. wwww�wuureaaa uvmuu�wwmmmmmomom wwu� ti� .... .... ��_,...�........................ ..,....... Re wired Prior to Submittal to Board Legal Attorney Name: Clara McDaniels 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 the w LAgreement Professional Services Bid Opening ❑ Quote Opening El Change Order No. Ease/Encroach. Other: Michael Schmidt )riate Item Ty..:- Contract Resolution for All Submissions I Proposal Bid Award ® Req. to Advertise ❑ Quote Award ❑ C/O & PCA No. ❑ PCA ❑ Traffic Control: Company or Vendor Name New Vendor MBE/WBE Contractor MBE/WBE Contractor Requested Project Name Project Number Funding Source Account No. Amount Required Information Yes LJ No MBE �_ VVBEWW�� If Yes Approved -Name of Comoanv Addendum ® Title Sheet Purchasi Mishawaka Avenue.T Traffic Si nals at Fire Station No. 9 ..........................!.._......_. �. 117-120A Terms of Contract _ ..........ww. Purpose/Description The project is to be advertised on January 25 and February 1 with bids opened on February m 12 Toy has the Title Sheet, E] Required Contractor's Certification Forms Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) �... _ ... _ .... meuiange Orders red For ChOnl _.:.... �....... m Amount of El Increase $ El Decrease $ Previous Amount � ................ � it �I� Current Percent of Change: % tf ..... New Amount Total Percent of Changmmm .. w % Dismersal After Aooroval Copy Original-� �- m.. El El