HomeMy WebLinkAboutRequest to Advertise - Ironwood Drive Pavement Rehabilitation Proj No 117-071BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date January 12, 2018
Name Roger Nawrot
BPW Date January 23, 2018
Department Public Works
Division/Bureau Engineering
Phone Extension 5932
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
forAll Submissions
El Agreement
El Contract
El Proposal El Addendum
EJ Professional Services
F1 Resolution
E] Bid Opening
El Bid Award
M Req. to Advertise Title Sheet
El Quote Opening
El Quote Award
0 Change Order No.
P C/O & PCA No.
F-1 PCA
❑ Ease/Encroach.
F-1 Traffic Control:
F-1 Other:
Required Information
Company or Vendor Name
New Vendor
El Yes El No El If Yes, Approved by Purchasing
MBE/WBE Contractor
[:1 MBE [:1 WBE
MBEANBE Contractor Requested
E] No E] Yes Name of Company
Project Name
Ironwood Drive Pavement Rehabilitation
Project Number
117-071
Funding Source
Account No.
Amount
$
Terms of Contract
Purpose/Description
Advertisement for bids on February 9 & 16 with bids received on
February 27.
F-1 Required Contractor's Certification Forms Attached (Non -
Collusion, Non-Discrjmination, Non -Debarment, E-Verify, Iran, etc.)
Required For Change Orders Only
Amount of F-1 increase
R Decrease
$
$
Previous Amount $
API)ROVUD
Current Percent of Change-,
% (if ni WW'ks
New Amount $
I A k 11 C) Q .'1 4 11
Total Percent of Change:
%
Dispersal After Approval
Copy Original
Kara Boyles
El
El R