HomeMy WebLinkAboutRequest to Advertise - Tucker Drive Project No 116-118ADate
Name
BP W Date
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
March 5, 2018
Roger T. Nawrot
March 13, 2018
Department
Division/Bureau
Public Works
Engineering
Phone Extension 5932
Required Prior to Submittal to Board
Legal Z Attorney Name: Michael Schmidt
Controller z 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 z
Check the
LJ'Agreement
F-1 Professional Services
❑ Bid Opening
Quote Opening
Change Order No.
El Ease/Encroach.
R Other:
Company or Vendor Name
iropriate Item Type —
Ell Contract
El Resolution
[:] Bid Award
F-1 Quote Award
El C/O & PCA No.
El Traffic Control:
for.All Submissions
I Proposal
Z Req. to Advertise
aired Information
NMI
FA
Vr4M_T a ql"'"
._ 11
E] Title Sheet
El Yes Z No If Yes, Approved by
New Vendor Purchasing
MBEANBE Contractor [:] MBE [J WBE
MBEANBE Contractor Requested E No [:] Yes Name of Company
Project Name Tucker Drive
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
11 6-118A
RWTD
324-1050-460.3102
Bids to be taken at the April 10 meeting.
F1 Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
F1 Increase $ "eard of pfrIJ 7Amount of F-1 Decrease $ U4,
Previous Amount $
Current Percent of Change: %
New Amount $
Total Percent of Chanae: %
Copy
Original
F-1
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F-1
F-1
El
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