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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />. _�....... - <br />Date 01/27/2020 _..... <br />Name Toy Villa <br />1 a Department 1:nI'roieerin <br />BPW Date 2/11/2020 Phone Extension 5920 <br />�_u� �,,��IT _ Rec��Kred Prior to Submittal to Board N p ®mm <br />BPW Attorney... ❑ Attorney Name <br />Dept. Attorney ❑ Attorney Name <br />__....... . _ _ .. <br />Purchasing <br />Check the ror Ite: "1 y fae — ?,1 114 <br />FI Professional Services Agreement <br />❑ Contract <br />Open Market Contract <br />El Amendment/Addendum <br />EJ Bid Opening <br />E' Bid Award <br />R Quote Opening <br />Quote Award <br />El Proposal Opening <br />❑ C/O & PCA No. <br />E] Chg. Order, No. <br />El Traffic Control <br />�' Other <br />Company or Vendor Name <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 />Amount of ❑I <br />❑ <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />New Completion Date: <br />red Information <br />Proposal <br />Special Purchase, QPA <br />Req. to Advertise <br />E] Reject Bids/Quotes <br />® PCA <br />❑ Resolution <br />Ease./Encroach <br />Larson Danielson Construction Co. Inc. <br />Ds❑ If Yes, ApprovedbyPurchasing <br />No <br />MBE Completed E-Verify Form Attached <br />F-] WBE <br />MorrisTheaterHandrails <br />119-074 <br />VPA Morris <br />416-0404-453.36-01 <br />�......... <br />$86,810.00 <br />Project Closeout <br />Orders <br />Increase $ <br />Decrease ($ <br />Increase % <br />Decrease <br />% <br />$ <br />Increase % <br />Decrease ( % <br />❑ Title Sheet <br />0 Yes <br />F] No <br />