HomeMy WebLinkAboutRequest to Advertise - 2016 Manhole and Sewer LiningDate
Name
11-1-16
Corbitt Kerr
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Department
Division/Bureau
Public Works
Engineering
BPW Date 11-08-16 Phone Extension 5931
Required Prior to Submittal to Board
Legal ❑ Attorney Name:
Controller ❑ Controller review is required for all Contracts $5,000.00 or more and
greater than one year in length per the City Purchasing Policy
Purchasing ❑
Check the Appropriate Item Type — Required for All Submissions
❑
Agreement
❑ Contract ❑ Proposal ❑ Addendum
❑
Professional Services
❑ Resolution
❑
❑
Bid Opening
Quote Opening
❑ Bid Award ® Req. to Advertise ❑ Title Sheet
❑ Quote Award
❑
Change Order No.
❑ C/O & PCA No. ❑ PCA
❑
Ease/Encroach.
❑ Traffic Control:
R
Other:
Company or Vendor Name
New Vendor
MBE/WBE Contractor
MBE/WBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Amount of ❑ Increase
❑ Decrease
Previous Amount $
Current Percent of Change:
New Amount $
Total Percent of Chance:
Copy
Original
❑
❑
❑
❑
❑
❑
❑ Yes ❑ No ❑ If Yes, Approved by
J WBE
Yes Name of C
hole and Sewer
11
Utility Expense / Contractual Service — Other
641-0621-792.63-35
NTB — 11/15, Advertise (I1/18. 11/25)
LJ Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
squired For Chance Orders Onlv
After
Works