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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 08/22/2019 <br />Department VPA: Facilities & <br />Name Patrick Sherman Grounds <br />BPW Date 08/27/2019 Phone Extension 5601 <br />iE uiu lw'L ,' ,WRRR;YIIIVIIRRfii f8IgNVdIN6f .uvicrwwmvmummaa�: �ih1 i'1�A3d0�9B I� NN' tlh10MOM .... pu✓lUIl11 V' "iBW:' INNNNNN%Nl d'�iG' ._ df6�Jblpl9°X IMIMIMIMIMOIMUva <br />Reired Prior Submittal to Boa ......... �.� <br />Legal ® Attorney Name Clara McDaniels <br />Controller ® Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing ® Michael Schmidt <br />p��. Submissions <br />Check the Appr�nopContrlactm Type Required Pro//osa mis ww _�m ......... <br />�] Agreement ❑ Addendum <br />❑ Professional Services Resolution <br />❑ Bid Opening [ Bid Award E] Req. to Advertise ❑ Title Sheet <br />Quote Opening Quote Award <br />❑ Change Order No. ® C/O & PCA No. 1 ❑ PCA <br />Ease/Encroach. ❑ Traffic Control <br />Other: <br />Reluired Information <br />Company or Vendor Name Acorn Landscapinq LLC <br />New Vendor <br />Ej Yes R No ❑ If Yes, Approved by Purchasing <br />MBE/WBE Contractor <br />[_1 MBE ❑ WBE <br />MBE/WBE Contractor Requested ® No ❑ Yes Name of Company <br />Project Name <br />2.0.1.9.....C..!.tv....C.emetery Paths <br />Project Number <br />..............................................._. <br />1084-2019 <br />Funding Source <br />COIT <br />Account No. <br />408-1001-4....� __Y_____ m..�_................�.�.._� <br />60.42-01 <br />Amount <br />$ 50,000.00 <br />Terms of Contract <br />.. .. �� m..... ...... _..... ._ <br />45 Da sy : 3737 lin/ft <br />Purpose/Description <br />Phase 2: Resurfacing of over rown paths in C y. <br />City Cemete <br />® Required Contractor's Certification Form Attached (Non - <br />Collusion„ Non Discrimination, Non Debarment, erN,ran, etc <br />R aired For ChanaeOrders Ong � _ � ....... <br />Amount of <br />...... <br />Increase __$ 3,170.00 <br />Decrease <br />Previous Amount <br />$ 46,830.00 ------ <br />.......... ..... .... <br />Current Percent of Change 0% <br />New Amount <br />$ 5 000.00 <br />Total Percent of Change: 6.8% <br />Dispersal After Approval <br />Copy <br />Original <br />El <br />El <br />n <br />F] <br />1-1 <br />El <br />