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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 8/6/19 Department Public Works <br />Name Kyle Silveus Division/Bureau Engineering <br />BPW Date S fis Phone Extension 9083 <br />. . ........ - — --------- Re aired Prior �to Submittal to Board�_,_. . . ................. <br />Legal El Attorney Name: Clara McDaniels <br />Controller El 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 E] Michael Schmidt <br />F_ Check the AwroDriate Item Twe - Required for All Submissions <br />" Agreement <br />Fj Professional Services <br />E] Bid Opening <br />F-1 Quote Opening <br />M Change Order No. 1 <br />F-1 Ease/Encroach. <br />0 Other: <br />Contract <br />❑ Resolution <br />El Bid Award <br />El Quote Award <br />C/O & PCA No. <br />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 />Proposal <br />IFIX05154-mrs <br />0 Req. to Advertise El Title Sheet <br />E] PCA <br />)n <br />St. Joseph Streetscape <br />118-008 <br />­­­­__ ........................ --- ... <br />SOUTH SIDE DEVELOPMENT TIF <br />­­­ --- __ . ... .............. <br />430-1050-460-42.02 <br />.................... <br />$26,436.52 <br />Purpose/Description Final Quantity Adjustment, Differing site conditions which <br />r _fqquied additional full depth ptcNM2 n <br />. .. . ... ........ _qd sbqrade treatment. . ..... u_____ <br />❑ Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />-777 -7"7 <br />. ....... ... .. <br />Amount of Incea <br />se $26,436-52 .......... <br />El eease <br />Previous Amount $ 423,000.00 <br />..... - - - — — ------------ --------­­------ Current Percent of Change- 6.25% <br />...... . . . . . ........... <br />New Amount $ 449,436.52 <br />Total Percent of Change-, 6.25% <br />Disoersa,l After Ao oro va I <br />Copy <br />Original <br />1:1 <br />1:1 <br />1:1 <br />El <br />n <br />1:1 <br />