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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 2/5/19 <br />Name JKyle Silveus Department Engineering <br />BPW Date 2/12/19 Phone Extension 9083 <br />Required Prior to Submittal to Board <br />Legal Attorney Name Clara McDaniels <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 F-1 Michael Schmidt <br />Check the <br />LJ Agreement <br />Professional SeNyes <br />❑ Bid Opening <br />Quote Opening <br />Change Order No. <br />Ease/Encroach. <br />Other: <br />)ropriate Item Type - <br />Contract <br />Resolution <br />El Bid Award <br />El Quote Award <br />0 C/O & PCA No. <br />F1 Traffic Control <br />for All Submissions <br />I Proposal 1:1 Addendum <br />El Req. to Advertise El Title Sheet <br />Required Information <br />Company or Vendor Name Lochmueller Group, Inc <br />[:1 PCA <br />New Vendor El Yes Z No El If Yes, Approved by Purchasing <br />MBEANBE Contractor F-1 MBEF-1 WBE <br />MBE/WBE Contractor Requested 0 NoF_1 Yes Name of Company <br />Project Name Leeper Park Improvement Project <br />Project Number 118-010 <br />Funding Source RW TIF Bond <br />Account No. 452-1101-452-31.02 - - — - - - - ------------­------- - -------- . .... ... <br />Amount $ 253,217.00 P <br />. . . . ......... ­­­_­_ <br />Terms of Contract Lump Sum <br />4 <br />Purpose/Description Amendment to PSA for Desig�mmn Services and Bid Document <br />Preparation <br />F-1 Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verifv,, Iran, etc.} <br />Amount of increase $ <br />Decrease $ <br />Previous Amount $ <br />Current Percent of Change-, <br />New Amount <br />Total Percent of Change: <br />Dispersal After Approval <br />Copy <br />Original <br />El <br />E] <br />n <br />F-1 <br />n <br />El <br />