Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 03/27/2019 <br />Name Toy Villa Department Engineering <br />BPW Date 04/09/2019 Phone Extension 5920 <br />..... _.......... <br />-- ... -_.... _ .._ <br />Required Prior to Submittal to Board <br />Legal ❑ Attorney Name <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 ❑ Michael Schmidt <br />................ <br />Check the <br />H Agreement <br />[l Professional Services <br />E] Bid Opening <br />❑ Quote Opening <br />Change Order No. _ <br />F Ease/Encroach. <br />Other: <br />Nmpriate Item Typeww— <br />Contract <br />[:] Resolution <br />Bid Award <br />R Quote Award <br />❑ C/O &PCANo. <br />_ <br />[:] Traffic Control <br />for All Submissions <br />] Proposal [l Addendum <br />❑ Req. to Advertise ❑ Title Sheet <br />ired Information <br />Company or Vendor Name Martell Electric, LLC <br />New Vendor ❑' Yes ❑ No ❑ If Yes, Approved by Purchasing <br />MBE/WBE Contractor ❑ MBE ❑ WBE <br />MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company <br />Project Name Angela Bridge Liahtinc <br />Project Number 116-111 <br />Funding Source COIT <br />Account No. 404.0602.431.31.06 <br />Amount $-.._w_.69 _ ._.... . <br />51,996.69 <br />Terms of Contract <br />Purpose/Description Project Closeout <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment., E-Verif , Iran, etc. <br />Required For Chanute Orders Qnj <br />Amount of ❑l inEl cease ._..case $ <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Copy <br />Original' <br />❑ <br />❑ <br />❑ <br />❑ <br />Dispersal AftermmApproval <br />-._. _.. <br />