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HomeMy WebLinkAboutRequest to Advertise - Erskine Clubhouse Renovation Project No 116-108BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST" FORM Date 05/15/2018 Name _K �le S�i veus Department Engineering BPW Date 05/22/2018 Phone Extension 5601 . .. . . ..... Required Prior to Submittal to Board Legal F-1 Attorney Name Clara McDaniels Controller o 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 ❑ Michael Schmidt Check the Appropriate Item Type - Required for All Submissions El Agreement F-1 Contract Proposal El Addendum El Professional Services F Resolution F-1 Bid Opening F Bid Award Z Req. to Advertise El Title Sheet F-1 Quote Opening E] Quote Award ❑ Change Order No. F C/O & PCA No. F-1 PCA Ease/Encroach. F-1 Traffic Control F-1 Other: Required Information Company or Vendor Name TBID New Vendor ❑ Yes [] No E] If Yes, Approved by Purchasing MBEANBE Contractor ❑ MBE F-11 WB,E MBENVBE Contractor Requested [:] No R Yes Name of Company Project Name Erskine Clubhouse Renovation Project Number 116-108 Funding Source SS TIF Account No. 430-1050-460-42.02 Amount $ TBD Terms of Contract Base bid with alternates Purpose/Description Renovation of clubhouse at Erskine Golf Course E] Required Contractor's Certification Form Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc. Required For Change Orders Only Amount of El increase $ EJ Decrease $ &P.P40vu) Previous Amount Jot&t Current Percent of Change: % MhV r) I I)MA /1 New Amount $ V s Total Percent of Change: % Dispersal After Approval Copy Original R F-1 F-1 El El El