Project Completion Affidavit - Three Twenty at the Cascade Composite Wall Panels Project No 118-074C - Construction Ahead Inc

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 09/04/2019 Department Public Name Toy Villa-:4 Works BPW Date 09/24/2019 Phone Extension 5920 00000n000000000mmmmimmmNo... rrawmm� momomomomo�mmm�ueruoxommmimoirrv�ma�ra�n gram d Prior to Submittal to Board _.................... l �.__ ..� . �.............. .................... _....._................. BPW Attorney [ Attorney Name Dept. Attorney] Attorney Name Purchasing E] ......... ....... _...... ...... ......... ...... _. ... _ Check the pp npri tIT Item Type ` / rgyh cl All Submissions E] Professional Services Agreement [� Contract Proposal El Open Market Contract ❑ Amendment/Addendum ❑ Special Purchase, QPA Bid Opening [:] Bid Award ❑ Req. to Advertise ❑ Title Sheet EJ Quote Opening E] Quote Award Reject Bids/Quotes E] Proposal Opening C/O & PCA No. ® PCA Chg. Order, No. Traffic Control ❑ Resolution Other: Ease./Encroach Required u i red. Information Company or Vendor Name Construction Ahead, Inc. Yes If Yes, Approved _....0 New Vendor � pp d by Purchasing No MBE/WBE Contractor ❑ WBE Completed E-Verify Form Attached Yes BE ❑ No J p Panels Division A Project Name 320 at the Cascade Composite Wall Panmmmm v.... Project Number 118-074C Funding Source River East TIF _ Account No. 429-1050-460-42.02 mm Amount $174,729.00 Terms of Contract ......... ..... _ .. .......w Purpose/Description Prp'ect Clo qr utt _..... mm._ .._. For Ch �itg Orders Only Amount of ❑ Increase $ ❑ Decrease ($ ) w� Previous Amount $ _............._%.... Increase Current Percent of Change: Decrease New Amount $ .....................................�.�.�.�.................._...w_ Increase ° /o Total Percent of Change: Decrease Time Extension Amount: New Completion Date: