Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 6/11/2019 <br />Department Public <br />.. e <br />Name Toy Villa <br />... —.... �. .�.�....A.. Works <br />... _... .... —.... _ .._. _.. <br />BPW Date 6/25/2019 Phone Extension 5920 <br />mmEmmwm w�m�n�����rnn�c... uwuwwwwmmmmarmmr iuiuiuiuurtai.... . �M �... mimuim a uuuuu�uuw <br />Required Prior to Submittal to Board <br />BPW Attorney Attorney Name <br />Dept. Attorney <br />Purchasing <br />R Attorney Name <br />Check the <br />Item T ry — Reauire &P, All Sub <br />LJ Professional Services Agreement LJ Contract <br />Open Market Contract <br />El Amendment/Addendum <br />El Bid Opening <br />EJ Bid Award <br />j Quote Opening <br />E Quote Award <br />[]' Proposal Opening <br />E] C/O & PCA No. <br />E] Chg. Order, No. <br />E] Traffic Control <br />Other: <br />Company or Vendor Name F <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Information <br />Lj Proposal <br />E] Special Purchase, QPA <br />Req. to Advertise <br />❑ Reject Bids/Quotes <br />® PCA <br />Resolution <br />Ease./Encroach <br />and Design, Inc. <br />❑ Title Sheet <br />U Yes" If Yes, Approved by Purchasing <br />® No <br />❑ MBE Completed E-Verify Form Attached ❑ Yes <br />F] WBE No <br />Lot 12 Landscape Work <br />119-029 S 31 Industrial Park Lanca m � <br />River West TIF <br />324-1050-460-42.01 - .Ol <br />52 110.00 <br />Project Closeout <br />�� .... <br />..�..�.�.� ... For Cki�,ui� Orders �aa,....._. ��.�__... ..�.. �..._�_....�w � �...... <br />Amount of ❑ Increase $ <br />El Decrease ($ ) <br />Previous Amount $ <br />Increase /o <br />Current Percent of Change: Decrease %) <br />New Amount $ _ <br />Increase.....�................._.......�...........................% ..............���m�.. �...................�.�...�......�..�,....�............w..................�......��................... <br />Total Percent of Change: Decrease..........��%)...............m....................�_....._�... _......�................ _..r. <br />Time Extension Amount: <br />... .m.. ... .......... m.. <br />New Completion Date: <br />