Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 6/28/2019 Department Public Works <br />Name Kyle Silveus Division/Bureau Engineering <br />BPW Date 7/9/2019 Phone Extension 9083 <br />rau�m�umuu�mrvr�mu�eea�w.�m�w�wmww�uwa,��r�� ,�, rmre � ,. a�rrrommmmmm�^rv�miumu�umumwommm�m�mmwmr�rmi�rverc��II <br />Required Prior to Submittal to Board <br />_...._............. .. ....... <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 />JI Agreement <br />E] Professional Services <br />] Bid Opening <br />f 1 Quote Opening <br />® Change Order No. 1 <br />I❑ Ease/Encroach. <br />Other: <br />Michael Schmidt <br />iropriate Item Type — Required for All Submissions <br />] Contract Proposal <br />] Resolution <br />Bid Award ❑ Req. to Advertise <br />Quote Award <br />El C/O & PCA No. ❑ PCA <br />El 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 />Environmental Glass <br />Yes L] No U If Yes, Ap roved b r_Purchasi <br />MBE [] WBE <br />No F] Yes Name of Comeanv <br />Addendum <br />❑ Title Sheet <br />LibertvTower . <br />Exterior Renovations <br />_......................................................m.... <br />118-086R................................................. <br />RWDA TIF <br />24-1 50-460-42-02 <br />-$4,227.32 <br />Remove 2 doors and add curtain wall <br />U Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Required For Change Orders <br />Amount of <br />E increase $ <br />Decrease $-........... �w ...._ <br />4,227.32 <br />Previous Amount $ 304,000 <br />Current Percent of Change: -1.39% <br />New Amount $ 299.772.68 <br />