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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date February 4, 2019 <br />Name Becca Plantz <br />Department Public Works <br />Division/Bureau Engineering <br />BPW Date February 12, 2019 Phone Extension 5998 <br />Required Prior to Submitta <br />l to Board <br />Legal ❑ Attorney Name: Clara McDaniels <br />Controller ❑ 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 <br />Check the <br />H Agreement Amendment <br />❑ Professional Services <br />❑ Bid Opening <br />Quote Opening <br />® Change Order No. 1 <br />❑ Ease/Encroach. <br />F Other: <br />wropriate Item Type . <br />El Contract <br />F Resolution <br />for All Submissions <br />] Proposal <br />❑ Bid Award F] Req. to Advertise <br />❑ Quote Award <br />❑ C/O & PCA No. ❑ PCA <br />❑ Traffic Control: <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />MBE/WBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Required Information <br />Larson Danielson <br />Morris Theater Mezzanine Handrails <br />118-081 _ <br />VPA Morns PerformingArts Center Generalm Fund <br />101-0404-453.36-01�� <br />Addendum <br />❑ Title Sheet <br />Lump Sum <br />Change order for disassembly and reassemb <br />ly of auditorium <br />seats at the Morris Theater to mount handrails. <br />L J Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Required For q�nge Orders Only _ . ... <br />Increase $ 625 00 _._. <br />Amount of Decrease $ <br />Previous Amount $ 22,900.00 <br />Current Percent of Change: 2.73% <br />New Amount $_W................_ <br />23„525.00 <br />Total Percent of Change: 2.73% <br />Dispersal After Approval <br />Copy Original <br />® ❑ Becca Plantz <br />El El <br />