Change Order No 1-PCA - Off Street Parking Lot at Wayne St and St Louis Blvd Project No 117-083B - Rieth Riley Construction Co Inc

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 04/11 /2019 Department Public Works ._........................... Name Toy Villa Division/Bureau Engineering BPW Date 04/23/2019 Phone Extension 5920 Required Prior to Submittal to Board Legal F-] Attorney Name: Controller El 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 " Agreement Professional Services ❑ Bid Opening Quote Opening Change Order No. _ Ease/Encroach. Other: Company or Vendor Name �ropriate Item Ty e D Contract Resolution Bid Award ❑ Quote Award ® C/O &PCANo ❑ Traffic Control: New Vendor MBE/WBE Contractor MBE/WBE Contractor Requested Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description Required for All Submissions �.... � Proposal............ WWWWW Req. to Advertise 1 Final ❑ PCA ired Information Rieth-Riley eConstruction Co Inc m........ El Yes ❑ No EJPurchasing MBE ❑ WBE EJ -No.....M Yes Name of wCo�� c Blvd. OffSiteParkin at St Louis 117-083B Park and -B 471.1131 m452.42.03 Proiect Closeout Addendum ❑ Title Sheet If Yes, Approved by and Wa Street ❑ Required Contractor's Certification Forms Attached (Non - Collusion, Non -Discrimination, Non -Debarment„ E Vernf r, Iran, etc. ._.. _..._ .... Required For Change Orders Only Amount of ® Increase $ 2,,516 23 ❑ Decrease $ Previous Amount $ 379,986.95 Current Percent of Change: 0.66% wwwww _. .......... ...... _....... _ .....__... New Amount $ 382,503.18 Total Percent of Change: 0.66% Dispersal After Approval Copy Original ❑ El El D El