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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 09/14/2020 <br />Department En gineering <br />Name Toy Villa <br />BPW Date 09/22/2020 Phone Extension5920 <br />Required Prior to Submittal to Board <br />BPW AttorneyAttorney Name <br />Dept. Attorney Attorney Name <br />Purchasing <br />Check the Appropriate Item Type – Required for All Submissions <br /> Professional Services Agreement ContractProposal <br /> Open Market Contract Amendment/Addendum Special Purchase, QPA <br /> Bid Opening Bid AwardReq. 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 NameWalsh & Kelly, 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 315 & 319 W. Jefferson Exterior Renovations – Division C <br />Project Number 119-064,Div. C <br />Funding Source RWDA TIF <br />Account No. 324.1050.460.42.02 <br />Amount $43,075.00 <br />Terms of Contract <br />Purpose/DescriptionProject Closeout. <br />For Change Orders Only <br />$ <br />Increase <br />Amount of <br />Decrease ($ ) <br />Previous Amount $ <br />% <br />Increase <br />Decrease(%) <br />Current Percent of Change: <br />New Amount $ <br />% <br />Increase <br />Decrease(%) <br />Total Percent of Change: <br />Time Extension Amount: <br />New Completion Date: <br />