Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 12/3/2019 <br />Department Public <br />Name Becca Plantz Works <br />BPW Date 12/10/19 Phone Extension 5998 <br />Re uired Prior to Submittal to Board <br />BPW Attorney Z Attorney Name Clara McDaniels <br />Dept. Attorney E] Attorney Name <br />Purchasing El...�._..._._.�_.��� ........................a....�� <br />Check the A rho riq Item Type — Ree 1i <br />Professio <br />nal Services Agreement Contract <br />Open Market Contract Amendment/Addendum <br />R Bid Opening Bid Award <br />Quote Opening ® Quote Award <br />Proposal Opening ❑ C/O & PCA No. <br />❑ Chg. Order, No. [ Traffic Control <br />❑ Other: <br />ltequi.rd Information <br />All Submissions <br />LJ Proposal <br />Special Purchase, QPA <br />Req. to Advertise <br />E] Reject Bids/Quotes <br />[:] PCA <br />Resolution <br />❑ Ease./Encroach <br />❑ Title Sheet <br />Company or Vendor Name <br />CalTeLService Outlet Inc. �._______......... w. <br />.F1 <br />. <br />Yes If Yes, Approved by Purchasing <br />New Vendor <br />❑ No <br />MBE <br />MBE/WBE Contractor <br />Completed E-Verify Form Attached ❑ Nos <br />❑ <br />Project Name <br />Bendix Theater Flooring <br />Project Number <br />119 106 <br />Funding Source <br />Hotel Motel Tax Fund......_ <br />... ................................_.................._.�......... <br />Account No. <br />7304.42010.000.009.. ._............_._._._._._.._ .........._... <br />Amount <br />.............. <br />$7 ��.....��.....��...���........................................w_....._�������������� .. <br />2,642.00 <br />Terms of Contract <br />Lump Sum <br />Purpose/Description <br />.. ....... ....... .... <br />Remove and 1, cc flooring; in Bendix Theater. <br />Amount of <br />Previous Amount <br />❑ Increase <br />Decrease <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />New Completion Date: <br />$ <br />Increase % <br />Decrease �(............................ <br />Increase % <br />Decrease ( % <br />