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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date8/17/20DepartmentPublic Works <br />NameKyle SilveusDivision/BureauEngineering <br />BPW Date8/25/20Phone Extension5932 <br />Required Prior to Submittal to Board <br />LegalAttorney Name:Clara McDaniels <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 />AgreementContractProposalAddendum <br />Professional ServicesResolution <br />Bid OpeningBid AwardReq. to AdvertiseTitle Sheet <br />Quote OpeningQuote Award <br />ChangeOrder No. 1C/O & PCA No. PCA <br />Ease/Encroach.Traffic Control: <br />Other: <br />RequiredInformation <br />Company or Vendor NameMartell Electric, LLC <br />YesNoIf Yes, Approved by <br />New VendorPurchasing <br />MBE/WBE ContractorMBEWBE <br />MBE/WBE Contractor RequestedNo Yes Name of Company <br />Project NameEwing Avenue and Fellows Street Traffic Signal Replacement <br />Project Number 118-097 <br />Funding SourceLRSA Traffic Signal Maintenance <br />Account No.251.0608.431.36-67 <br />Amount-$5,745.96 <br />Terms of Contract <br />Purpose/Description <br />Final quantity adjustments resulting in an overall underrun. <br />Required Contractor’s Certification FormsAttached(Non- <br />Collusion, Non-Discrimination, Non-Debarment, E-Verify, Iran, etc.) <br />Required For Change Orders Only <br />$ <br />Increase <br />Amount of <br />Decrease$$5,745.96 <br />Previous Amount$194,604.50 <br />Current Percent of Change: -2.95% <br />New Amount$188,858.54 <br />Total Percent of Change:-2.95% <br />Dispersal After Approval <br />Copy Original <br />