Change Order No 3 - Historic Leeper Park Improvements Project No 118-010A - Ancon Construction

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date Name BPW Date 9/17/19 Kvle Silveus 9/24/ 19 Department Phone Extension Engineering 9083 Rewired Prior to Submittal to Board. Legal Attorney Name Clara McDaniels Controller Controller review is required for all Contracts $5,000.00 or more anc greater than one year in length per the City Purchasing Policy Purchasing F-1 Michael Schmidt Check the Agreement Professional Services [:] Bid Opening ❑ Quote Opening ® Change Order No. 3 [l Ease/Encroach. F 1 Other: iropriate Item Type Contract F] Resolution ❑ Bid Award ❑ Quote Award El C/O & PCA No. _ ❑ Traffic Control I )r AH Submissions Proposal ❑ Addendum ❑ Req. to Advertise ❑ Title Sheet ❑ PCA on Company or Vendor Name Ancon Construction Company, Inc. New Vendor ❑ Yes ❑ No ❑ If Yes, Approved by Purchasing MBE/WBE Contractor ❑ MBE ❑ WBE MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company Project Name Historic LeeperwPark Improvements — Bid Package 1 18-010A Project Number 1.�.�.....____....... w.�. .......... m�. Funding Source RW TIF Bond wwwwwwwwwwwww��w�w....wwwwwwwww ,,._. Account No. 452-1101-452-31.02 Amount $ 27,017.29 Terms of Contract Purpose/Description Security Pole, Panel Upgrade. and Quantity Adjustments ❑ Required Contractor's Certification Form Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify+„ Iran, etc. fired Foriu Qrders Oni Increase $ 27„017 29 Amount of wm .... ..................................................... �.. ❑ Decrease $ Previous Amount $ 1,345,797.07 Current Percent of Change: 2.01 % ...................................................................... New Amount $1,372,814.36 Total Percent of Change: 4.94% Dispersal After Approval Copy Original ® ❑ Kyle Silveus ® ❑ Patrick Sherman __...... --�------------- _..�..�.�...�......---------