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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 05/05/2020 <br />Department Engineering <br />Name Toy Villa <br />BPW Date 05/12/2020 Phone Extension 5920 <br /> <br />Required Prior to Submittal to Board <br />BPW Attorney Attorney Name <br />Dept. Attorney Attorney Name <br />Purchasing <br />Check the Appropriate Item Type – Required for All Submissions <br /> Professional Services Agreement Contract Proposal <br /> Open Market Contract Amendment/Addendum Special Purchase, QPA <br /> Bid Opening Bid Award Req. to Advertise Title Sheet <br /> Quote Opening Quote Award Reject Bids/Quotes <br /> Proposal Opening C/O & PCA No. PCA <br /> Chg. Order, No. Traffic Control Resolution <br /> Other: Ease./Encroach <br />Required Information <br />Company or Vendor NameT. George Podell & Co., Inc. <br /> Yes If Yes, Approved by Purchasing <br />New Vendor <br /> No <br /> MBE Yes <br />MBE/WBE Contractor Completed E-Verify Form Attached <br /> WBE No <br />Project Name Main & Colfax Parking Structure PaintRemoval <br />Project Number 119-078R <br />Funding SourceParking Garages <br />Account No. 601.0462.645.36.01 <br />Amount$143,700.00 <br />Terms of Contract <br />Purpose/Description ___Project <br />Closeout_______________________________________________________ <br />_______________________________________________________________ <br />____________________________________________________ <br />For Change Orders Only <br />$ <br /> Increase <br />Amount of <br />Decrease ($) <br />Previous Amount $ <br /> % <br />Increase <br />Decrease (%) <br />Current Percent of Change: <br /> <br />New Amount$ <br /> % <br />Increase <br />Decrease (%) <br />Total Percent of Change: <br /> <br />Time ExtensionAmount: <br />New Completion Date: <br /> <br />