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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 12/03/2020 <br />Name <br />BPW Date <br />Alicia Pellegrino/Sue Ellen Doudrick <br />12/08/2020 <br />Department <br />Division/Bureau <br />an01myiy[•Tiw <br />Engineering <br />Phone Extension 5903 <br />Required Prior to Submittal to Board <br />Legal ❑ <br />Attorney Name: Clara McDaniels <br />Controller ❑ <br />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 ❑ <br />Check the Appropriate Item Type — Required for All Submissions <br />® Agreement Amendment <br />❑ Contract ❑ Proposal ❑ Addendum <br />❑ Professional Services <br />❑ Resolution <br />❑ Bid Opening <br />❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening <br />❑ Quote Award <br />❑ Change Order No. <br />❑ C/O & PCA No. ❑ PCA <br />❑ Ease/Encroach. <br />❑ Traffic Control: <br />I-1 Other: <br />Required Information <br />Company or Vendor Name Cardno, Inc. <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 St. Joseph Riverbank Stabilization <br />Project Number 118-005 <br />Funding Source Engineering Professional Services <br />Account No. 101-06-600-500 <br />Amount Amendment 4: $6,500.00 New Contract Amount: $113,100.00 <br />Terms of Contract Hourly Not to Exceed <br />Purpose/Description Construction administration support for the construction phase of <br />the North Shore Bank Stabilization Proiect <br />❑ Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Required For Change Orders Only <br />Amount of ❑ Increase $ <br />❑ Decrease $ <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />$ <br />