Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 1/21/2020.. _._.._.. _ ._..w......� _ ........... <br />Name Becca Plantz Department Public Works <br />BPW Date 1/28/2020 Phone Extension 5998 <br />M=MMM u. <br />Review and Approval Required Prior to Submittal to Boar .... <br />Diversity Compliance Officer Name <br />er <br />BPW Attorney Attorney Name Clara McDaniels <br />Dept. Attorney Attorney Name <br />Purchasing <br />Check the A <br />propriate Item "G Re <br />Professional Services Agreement <br />Contract <br />❑ <br />Open Market Contract <br />❑ Amendment/Addendum <br />EI Bid Opening <br />❑ Bid Award <br />�] Quote Opening <br />❑ Quote Award <br />Proposal Opening <br />❑ C/O & PCA No. <br />Chg. Order, No. <br />❑ Traffic Control <br />Other: <br />leruired Information <br />All Submissions <br />Proposal <br />EJ Special Purchase, QPA <br />Req. to Advertise <br />Reject Bids/Quotes <br />PCA <br />❑ Resolution <br />Ease./Encroach <br />❑ Title Sheel <br />Company or Vendor Name American Structurepoint Inc.mm mITITIT-mITITmmmITITITITITmm uwwww <br />New Vendor-�mYes❑ WIf Yes, Approved by Purchasing <br />No <br />MBE/WBE Contractor MBE Completed E-Verify Form Attached Yes <br />�] WBE No <br />Project Name Walker Field Park Shelterhouse <br />Project Number 120-010 <br />Funding Source F&G Operations Budget mm __wwww <br />Account No. 201.1101.452.39.89-....... ........... <br />..._.............................____................... ..................... <br />Amount $5,850.00 <br />Terms of Contract l usrq Sum_ _.......�............._...... <br />Purpose/Description _Structural engineering services to perform a structural condition assessme <br />of the Walker Field Park Shelterhouse. <br />WWWWWW <br />For ChangeITOrders wOnly <br />'w <br />Amount of Increase $$ — uu <br />❑ Decrease _........... <br />Previous Amount $ <br />Increase % <br />Current Percent of Change: Decrease ( % <br />New Amount $ <br />Increase % <br />. ._............ _......_................ <br />_. ._... <br />Total Percent of Change: Decrease (m IT mmmmmmmmmmm m%)mmmmm mmmm mwwwwwwwwwwmmmmm wwwa <br />Time Extension Amount: <br />�.mm._ _...... <br />New Completion Date: <br />