PSA - Erskine Drainage Improvements Study - McCormick Engineering, LLC.

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date December 16, 2019 Name Roger Nawrot Department Public Works Division/Bureau Engineering BPW Date December 19, 2019 Phone Extension 5932 to B required Prior to Submittal Board ........_ .__ ...-.-_ ....-_ .......................... ..__... Legal ® Attorney Name: Clara McDaniels Controller ❑ Controller review is required for all Contracts $5,000.00 or more and greater than one year in length per the City Purchasing Policy Purchasing Checkthe E Agreement Professional Services F-1 Bid Opening Quote Opening ❑ Change Order No. E] Ease/Encroach. Ej Other: Company or Vendor Name pro riate Item T /e' ❑ Contract n Resolution [l Bid Award ❑ Quote Award C/O & PCA No. ❑ Traffic Control: New Vendor MBE/WBE Contractor MBE/WBE Contractor Requested Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description Required Inform ed for All Submissions [] Proposal Req. to Advertise McCormick Engineering, LLC PCA Addendum ® Title Sheet El Yes ❑ No ❑ If Yes, Approved by Purchasing MBE 0 Wg. .............._. �..._�._............ E No Yes Name of Co. mpaniy __ .____.... _ ...... Erskine Drainage Improvement Study .. ..... 120-013 .......................... n.............._.... Professional Services 101-0602-431.31-06 ._ ............................ Not to Exceed ---....._............. _. U Required Contractor's Certification Forms Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) For Chancie Orders Amount of ❑ Increase $ ❑ Decrease $ Previous Amount $ Current Percent of Change: ......................... New Amount $ Total Percent of Chaooe: Dispersal After Approval Copy Original El 1:1 E]