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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 8/17/20 <br />Department <br />Name Kyle SilveusEngineering <br />BPW Date 8/25/20 Phone Extension 9083 <br />Required Prior to Submittal to Board <br />LegalAttorney 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 />AgreementContractProposalAddendum <br />Professional ServicesResolution <br />Bid OpeningBid AwardReq. to AdvertiseTitle Sheet <br />Quote OpeningQuote Award <br />ChangeOrder No. 1 C/O & PCA No. PCA <br />Ease/Encroach.Traffic Control <br />Other: <br />RequiredInformation <br />Company or Vendor Name Majority Builders, Inc. <br />__________________________________________________ <br />New Vendor YesNoIf Yes, Approved by Purchasing <br />MBE/WBE Contractor MBEWBE <br />Project Name Main St. &Wayne St. GarageImprovements <br />Project Number 119-066 <br />Funding Source RWDA <br />324-1050-460-42.02 <br />Account No. <br />Amount$9,053.00 <br />Terms of Contract <br />Unforeseen conitions once the canopy was removed. Additional formed <br />Purpose/Description <br />and surface patching of exposed rebar for protection <br />Required Contractor’s Certification Form Attached(Non- <br />Collusion, Non-Discrimination, Non-Debarment, E-Verify, Iran, etc.) <br />Required For Change Orders Only <br />$9,053.00 <br />Increase <br />Amount of <br />Decrease$ <br />Previous Amount$428,914.00 <br />Current Percent of Change: 2.11% <br />New Amount$437,967.00 <br />2.11% <br />Total Percent of Change: <br />Dispersal After Approval <br />Copy Original <br />