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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 02/04/2019 <br />. . . ..................... Department Public Works <br />Name Roger Nawrot <br />. .............. <br />Division/Bureau Engineering <br />........................ - <br />BPW Date 02/12/2019 <br />Phone Extension 5920 <br />Legal <br />Attorney Name: <br />Controller <br />Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing El <br />. ................... <br />Check the Appropri <br />. .......Type- -Re uired for A Submissions <br />ate —I <br />Agreement <br />IE] <br />Contract Proposal El Addendum <br />Professional Services <br />[_1 <br />Resolution <br />E] <br />Bid Opening <br />E] <br />Bid Award Req. to Advertise El Title Sheet <br />E] <br />Quote Opening <br />El <br />Quote Award <br />Change Order No. 1 <br />F-1 <br />C/O & PCA No, E], PCA <br />Ease/Encroach, <br />F-1 <br />Traffic Control: <br />E] <br />Other: <br />Required Information <br />Company or Vendor Name <br />Brown & Brown General Contractors, Inc. <br />El Yes [:] No mm If Yes, Approved by <br />New Vendor <br />Purchasing <br />MBEIWBE Contractor <br />MBE [:] WBE <br />MBEIWBE Contractor Requested ._D_No <br />. . ......................... <br />[:] Yes Name of Corn an <br />..... ................ . . ........ .. <br />Project Name <br />entu <br />Cry Center Convention Hall A-B Entry <br />....... ................. <br />Project Number <br />115-01 7A <br />Funding Source <br />...... . ... ........ _. .......... <br />Hotel -Motel <br />Account No. <br />.......................... <br />7304.42010.000.0099 <br />Amount <br />$75,552.00 <br />Terms of Contract <br />.. . ........... . ......... <br />Purpose/Description <br />Approval of C.0 #1 <br />F-1 Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E- ��!Jfy, Iran, etc. <br />........... .... . — . J . ........ <br />. .........Re faired For Change Orders Only <br />Amount of Increase $12,862.00 ............. <br />El Decrease <br />Previous Amount $75,552.00 <br />. . .............. . . .................... <br />Current Percent of Change: 17.02% <br />........................ <br />New Amount 88,414.00 <br />Total Percent of Chan e: 17.02% ............. . ...... <br />Percent .................... <br />Disoersal After At)r)roval <br />Copy <br />Original <br />❑ <br />El <br />El <br />