HomeMy WebLinkAboutRequest to Advertise - Off Site Parking at St Louis Blvd and Wayne St - Project No 117-083BBOARD OF PUBIAC WORKS
AGENDA ITEM RE, VIEW REQUEST FORM
Date June 4, 2018
Name Roger Nawrot
Department
Division/Bureau
Public Works
Engineering
BPW Date June 12, 2018 Phone Extension 5932
Required Prior to Submittal to Board
Legal 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 z
Check the Appropriate Item Type — Required for All Submissions
E] Agreement n Contract E] Proposal El Addendum
Professional Services F1 Resolution
Bid Opening 0 Bid Award Z Req. to Advertise M'Title Sheet
F-1 Quote Opening 0 Quote Award
E] Change Order No. ❑ C/O & PCA No. F] PCA
F1 Ease/Encroach. ❑ Traffic Control:
F1 Other:
Company or Vendor Name
New Vendor
MBE/WBE Contractor
MBE/WBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
uired Information,
El Yes [:] No E] If Yes, Approved by
Purchasina
[:] No [Ji Yes Name of Company _
Off Site Parking at St Louis Blvd. and Wayne Street
117-083B
Regional Cities
20,1-1111-452.31-06
Not to Exceed
LJ Required Contractor's Certification Forms Attached (Non,-
CoHusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
Required For Change Orders Only
Amount of F1 increase $
El Decrease $
Previous Amount
Current Percent of Change
New Amount
Total Percent of Change:
$ Of PrL,.
% .. ,
I Dispersal After ADDroval ?A10 I
Copy
Original
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