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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date October 28, 2019 Department Public Works <br />Name Alicia Czarnecki/Sue Ellen Doudrick Division/Bureau En <br />gineering <br />.................. _..... _.. �............ <br />_..._............. <br />BPW Date November 12, 2019 Phone Extension 5903 <br />VIVIVIVIIImIIIIW�IWI@IIIIIIIIIIIIIIIWWIIIIIIIIIIIIIIIIWVIVIVIVIVIVWWIVV!VUVwIVVWIVIVNINVNNWVI N <br />Required Prior to Submittal to Board <br />.. ..__........... ..... _uw_._.-.... <br />Legal (J 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 F' <br />Check the A <br />Agreement Amendment <br />❑ Professional Services <br />Bid Opening <br />Ej Quote Opening <br />❑ Change Order No. <br />Ease/Encroach, <br />F� Other: <br />)ropriate Item wT e — <br />ontract <br />C <br />F Resolution <br />for All Submissions <br />F Proposal <br />Bid Award ❑ Req. to Advertise <br />❑ Quote Award <br />El C/O & PCA No. ❑ PCA <br />❑ Traffic Control: <br />Rewired Information <br />Addendum <br />❑ Title Sheet <br />Company or Vendor Name Cardno, Inc. <br />Yes EJ No If Yes, Approved by <br />New Vendor Purchasin <br />MBE/WBE Contractor .........MBE D WBE_. .... <br />MBE/WBE Contractor Requested E] No Yes Name of Company <br />Project Name St. Joseph Riverbank Stabilization <br />Project Number 118-043 <br />Funding Source i.ltili y Expwense / Contractual Service <br />.... Fund <br />Account No. 251-0608-431-3106 (LRSA Professional Services <br />Amount Amendment 1: $59,600.00 New Contract Amount: $99,600.00 <br />Terms of Contract Lump Sum for design services; Not to Exceedmmmmmmmmm <br />Purpose/Description Engineering design services for bank stabilization on Riverside <br />-17 ow <br />Drive <br />Shore Iroquois, Leland. <br />Required Contra for sCe Certification Attache <br />d (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />nmm _ Required For Chan a Orders Onl mm <br />Amount of ❑ Increase $ <br />Decrease ....._...$ ..... _ ��..��� ................. _............. <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount mm....................... <br />Total Percent of Change: _._..............% <br />