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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date06/02/2020 Department Public Works <br />Name Toy Villa Division/Bureau Engineering <br />BPW Date 06/09/2020 Phone Extension 5920 <br /> <br />Required Prior to Submittal to Board <br />Legal Attorney Name: <br />Controller review is required for all Contracts $5,000.00 or more and <br />Controller <br />greater than one year in length per the City Purchasing Policy <br /> Purchasing <br />Check the Appropriate Item Type Required for All Submissions <br />Agreement Amendment Contract Proposal Addendum <br />Professional Services Resolution <br />Bid Opening Bid Award Req. to Advertise Title Sheet <br />Quote Opening Quote Award <br />Change Order No. C/O & PCA No. PCA <br />Ease/Encroach. Traffic Control: <br />Other: <br />Required Information <br />Company or Vendor Name Precision Wall Systems <br /> Yes No If Yes, Approved by <br />New Vendor Purchasing <br />MBE/WBE Contractor MBE WBE <br />MBE/WBE Contractor Requested No Yes Name of Company <br />Project Name - Glazed Assemblies <br />Project Number 118-074A <br />Funding Source <br />River East TIF <br />Account No. 429.1050.460.42.03 <br />Amount $1,504,666.00 <br />Terms of Contract <br />Purpose/Description <br />Project Closeout <br /> Required s Attached (Non- <br />Collusion, Non-Discrimination, Non-Debarment, E-Verify, Iran, etc.) <br />Required For Change Orders Only <br />$ <br /> Increase <br />Amount of <br /> Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy Original <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />