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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 11/16/20 <br />Name Kyle Silveus Department Engineering <br />BPW Date 11/24/20 Phone Extension 9083 <br /> <br />Required Prior to Submittal to Board Legal Attorney Name Clara McDaniels <br />Controller Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing Michael Schmidt <br />Check the Appropriate Item Type – Required for All Submissions <br /> Agreement Contract Proposal Addendum <br /> Professional Services Resolution <br /> Bid Opening Bid Award Req. to Advertise Title Sheet <br /> Quote Opening Quote Award <br /> Change Order No. 1 C/O & PCA No. PCA <br /> Ease/Encroach. Traffic Control <br /> Other: <br />Required Information <br />Company or Vendor Name Walsh and Kelly, Inc. <br />New Vendor Yes No If Yes, Approved by Purchasing <br />MBE/WBE Contractor MBE WBE <br />MBE/WBE Contractor Requested No Yes Name of Company <br />Project Name Two-Way Conversion of Colfax Ave. – Phase II <br />Project Number 115-053B <br />Funding Source River West Development Area TIF <br />Account No. 324-1050-460.42-01 <br />Amount <br />Terms of Contract Final Quantity Adjustment, Additional Seeding <br />Purpose/Description Required Contractor’s Certification Form Attached (Non- <br />Collusion, Non-Discrimination, Non-Debarment, E-Verify, Iran, etc.) <br />Required For Change Orders Only <br />Amount of <br /> <br />Increase <br />Decrease <br />$ 25,059.38 <br />$ <br />Previous Amount $ 594,900 <br />Current Percent of Change: 4.21% <br />New Amount $ 619,959.38 <br />Total Percent of Change: 4.21% <br />Dispersal After Approval <br />Copy Original <br /> <br /> <br /> <br />