Laserfiche WebLink
Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Engineering <br />Public Works <br />BPW Date 7/26/2016 Phone Extension 5998 <br />7/14/2016 <br />Blair Bennett <br />Department <br />Division/Bureau <br />I Required Prior to Submittal to Board <br />Legal ® Attorney Name: <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 Aii Submissions <br />Professional Services <br />Bid Opening <br />Quote Opening <br />Change Order No. 1 <br />Ease/Encroach. <br />Other: <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />MBE/WBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Contract <br />Resolution <br />Bid Award <br />Quote Award <br />C/O & PCA No. <br />Traffic Control: <br />❑ Req. to Advertise <br />❑ PCA <br />Addendum <br />❑ Title Sheet <br />Required Information <br />JJamco Construction, Inc. <br />❑ Yes ❑'No ❑ If Yes, Approved by <br />❑ No LJ Yes Name of Company <br />Hoffman Hotel Renovations <br />115-071 <br />West TIF <br />Window Replacement to Hoffman Hotel <br />Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />I Required For Chan a Orders Only <br />Amount of ® Increase $ 26,200 <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Chance - <br />Copy <br />Origin, <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />7 <br />18.11% <br />$ 170,899.37 <br />1-8 11% <br />