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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 9/29/2021 Department Public Works <br />Name Sue Ellen Doudrick Division/Bureau Engineering <br />BPW Date 10/12/2021 Phone Extension 5922 <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 <br />Check the Appropriate Item Type – Required for All Submissions <br /> Agreement Amendment 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. C/O & PCA No. PCA <br /> Ease/Encroach. Traffic Control: <br /> Other: <br />Required Information <br />Company or Vendor Name Cardno, Inc. <br />New Vendor <br /> Yes No If Yes, Approved by <br />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 118-005B <br />Funding Source Storm Sewer Fund <br />Account No. 667-06-605-517-431000 (PR-00012290) <br />Amount Amendment 5: $23,000 <br />Terms of Contract <br />Purpose/Description <br />Hourly Not to Exceed <br />Construction administration support for the construction phase of <br />the Riverside Bank Stabilization Project <br /> <br /> <br /> Required Contractor’s Certification Forms Attached (Non- <br />Collusion, Non-Discrimination, Non-Debarment, E-Verify, Iran, etc.) <br />Required For Change Orders Only <br />Amount of <br /> <br />Increase <br />Decrease <br />$ <br />$ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />