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 />... .. .. ..... <br />.... .A... <br />BPW Date 7/9/2019 Phone Extension 9083 <br />Reauired Prior to Submittal to Board <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 ❑ Michael Schmidt <br />Check the Appropriate Item ape — Required for All Submissions <br />[� <br />Agreement <br />El Contract ❑ Proposal El Addendum <br />® <br />Professional Services <br />❑ <br />Resolution <br />❑ Bid Opening <br />❑ <br />Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />Quote Opening <br />Quote Award <br />E] <br />Change Order No. <br />C/O & PCA No. ❑ PCA <br />❑ Ease/Encroach. <br />El <br />Traffic Control: <br />Other: <br />._._...._._..._._...._...._......_ <br />... Information Ie+t�ired..If._......... �......_ <br />Company or Vendor Name <br />HWC Engineeri � <br />New Vendor <br />❑I <br />Yes„ No If Yesr prove�� ���-�... <br />(� A d b Purchasm <br />MBE/WBE Contractor <br />MBE n WBE <br />MBE/WBE Contractor Requested [ <br />No n Ye_s. Name of Comp an <br />Project Name <br />Western Ave. Streetscape - Phase III <br />....._.. . <br />Project Number <br />118-076 <br />Funding Source <br />RWDA TIF <br />AccountNo. <br />324-1050-460-3�1.�_.���.........................................................._..................�.�_...........���_.__.................������...�m.. <br />Amount <br />....... <br />$100,825 <br />Terms of Contract <br />Hourly,_N ...._ ..__ �.. <br />Not to Exceed <br />Purpose/Description <br />Construction Inspection Services _ ��� ... <br />❑ Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />_....._ m...wwmmmmmmmmmmm ......w <br />vvvv vweuired For Chara�eOrdersmmmOnl�mv.vvv <br />Amount of Decrease $ <br />Previous Amount <br />$ <br />