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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date May 6, 2019 <br />mmmmm mm Name.......Ro..e.r....Nawrot.............. ,��..� .. ........ Department Engineering <br />BPW Date May 14, 2019 Phone Extension 5932 <br />uuw.�omomommuavvvvvmuwmrc�mriuwv omi�uwwu�e��Nrminrrrnttriic _. , �� ��� i xi wuuw im�mi�uwmmmmmmmmmmmmmuiuimmmuiuiuwwwwmw ma�eu�. <br />Required Pnor to Submittal to Board <br />..__...._ww .........._ .. _ _.._.... w ......._.... _._.__... <br />Legal ❑ Attorney Name Clara McDaniels <br />Controller Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing <br />Check the <br />LJ Agreement <br />R Professional Services <br />❑l Bid Opening <br />[l Quote Opening <br />Change Order No. <br />❑ Ease/Encroach. <br />Other: Amendment No. <br />)ruts Item_T m' .....-. <br />Contract <br />Resolution <br />or All _mubmissions <br />Proposal <br />El Bid Award ❑ Req. to Advertise <br />❑ Quote Award <br />❑ C/O & PCA No. ❑ PCA <br />❑ Traffic Control <br />Required Information <br />Addendum <br />❑ Title Sheet <br />Company or Vendor Name <br />Lawson -Fisher Associates P.C. <br />._.......... ........ .. �.�. ....... �_ ..........�_.._ <br />❑ Yes ® No ❑ If Yes, Approved by <br />New Vendor <br />Purchasing mmmmmmm <br />MBE/WBE Contractor <br />MBE � WBE __.,.... <br />MBE/WBE Contractor Requested <br />........ - ......... <br />[❑ No 0 Yes Name of Co ap................................ <br />Project Name <br />East Bank Trail Slope Stabilization Design Services <br />Project Number <br />118-306 mm mmm <br />Funding Source <br />Liability Insurance Fund <br />Account No. <br />226-0419-672.42-03 <br />Amount <br />$ 13 ,700.00 <br />Terms of Contract <br />NTE <br />Purpose/Description <br />The de si n of the necessa repairs to restore -�......�........ <br />the trail into safe <br />operation after the study phase. The total contract amount with <br />this amendment is 04,440.00. <br />Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />m� w�_ ........_........... eq ired For Change Orders n!. �.� .. <br />Amount of F1 Increase <br />$ <br />n Decrease <br />$ <br />Previous Amount <br />CurrentPercent of Change: <br />..�..�..�.........�.� <br />New Amount $ <br />...............................�.�.�.�....m............... �����.................................�........................�.... � ......-- <br />Total Percent of e <br />/0 <br />.- <br />Dis rsal After A proval <br />Copy Original <br />