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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />BPW Date <br />10/15/19 <br />Kyle Silveus <br />10/22/19 <br />Department <br />Phone Extension <br />Engineering <br />.................. <br />9083 <br />Re�uired Prior to Submittal to Board <br />Legal ❑ Attorney Name <br />Controller El Controller review is required for all Contracts $5,000.00 or more anc <br />greater than one year in length per the City Purchasing Policy <br />Purchasing 1:1 <br />J_J Agreement <br />F-1 Professional Services <br />F-1 Bid Opening <br />El Quote Opening <br />F] Change Order No. <br />0 Ease/Encroach. <br />F] Other: <br />Contract <br />Resolution <br />Bid Award <br />El Quote Award <br />F1 C/O & PCA No. <br />D Traffic Control <br />'Re' ullred In <br />Company or Vendor Name Majority Builders, Inc. <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Proposal <br />Addendum <br />El Req. to Advertise El Title Sheet <br />[:1 PCA <br />on <br />Yes JZJ No L] If Yes, Approved by Purchasing <br />MBE F-1 WBE <br />Main St. & Ap )y!L1!1 its <br />119-066 <br />. ............................ . . . . . ......................................... <br />RWDA <br />324-1050-460-42.02 <br />428,914.00 <br />Base Bid plus Alternates ............. .......... . . . ..... <br />Repairs to the Existing Parking Garage <br />F-1 Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment. E-Verifv, Iran, etc.) <br />Amount of El increase $ <br />El Decrease $ <br />Previous Amount $ <br />_ .................... <br />Current Percent of Change: --- �­­'­,_ <br />New Amount <br />Total Percent of Change: <br />Copy <br />Original <br />11 <br />El <br />0 <br />R <br />El <br />11 <br />. . ... . ................... ... . . . ................... . ...... ... <br />Dispersal After Approval <br />