HomeMy WebLinkAboutRequest to Advertise - Ravina Park Project No 117-073BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Name Alicia Czarnecki
Department
Division/Bureau
Public Works
Engineering
BPW Date 04/10/2018 Phone Extension 5903
Required Prior to Submittal to Board
Legal F-1 Attorney Name: Clara McDaniels
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 El
Check the Appropriate Item Type — Required for All Submissions
F1 Agreement Amendment ❑ Contract n Proposal ❑ Addendum
n Professional Services, Resolution
F1 Bid Opening El Bid Award 0 Req. to Advertise Title Sheet
EJ Quote Opening El Quote Award
El Change Order No. El C/O & PCA No.. F] PCA
F] Ease/Encroach. ❑ Traffic Control:
0 Other: General Release Reauired Information
Company or Vendor Name
New Vendor
MBE/WBE Contractor
MBEANBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
TBD
E-1 Yes F No ❑ If Yes, Approved by
Purchasing
[:1 MBE [:1 WBE
F1 No El Yes Name of Company
Ravina Park
117-073
FIRequired Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
Amount of E] Increase $ A DJ51�rj jjptp
El Decrease $
Previous Amount $ _.w VV
Current Percent of Change: % APR 10 ' 111k, 1 /7
New Amount $ 7�
WOM
Total Percent of Change: %
Disr)ersal After ftorozWASUP, -MIA A=
Copy
Original
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11
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F-1
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Kara Boyles, City E
Alicia Czarnecki
ineer