HomeMy WebLinkAboutRequest to Advertise - Michiana Brick Site Demolition - Project No. 116-138BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 01/13/2017 Department
Name Richard Estes Division/Bureau
Public Works
Engineering
BPW Date 01/24/2017 Phone Extension 5896
Required Prior to Submittal to Board
Legal ® Attorney Name: Michael Schmidt
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 ❑ George King
Check the Appropriate Item Type — Required for All Submissions
❑ Agreement ❑ Contract ❑ Proposal ❑ Addendum
❑ Professional Services ❑ Resolution
❑ Bid Opening ❑ Bid Award ® Req. to Advertise ❑ Title Sheet
❑ Quote Opening ❑ Quote Award
❑ Change Order No. ❑ C/O & PCA No. ❑ PCA
❑ Ease/Encroach. ❑ Traffic Control:
❑ Other:
Company or Vendor Name
New Vendor
MBEM/BE Contractor
MBE/WBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
uired Information
scneouie: 1Aa"1-ul//1, AdZ-UZ/U3, bids UUe U2/14 `
❑ Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
I Required For Change Orders Onlv I
Amount of
Increase
Decrease
Previous Amount $
Current Percent of Change: %
New Amount $
Total Percent of Change: %
Copy
Origin
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Patrick C Kerr
Aaron Kobb
Dave Sieradzki (Century Builders)