HomeMy WebLinkAboutRequest to Advertise - Gemini Washington-Colfax Apartment Improvements Project No 118-080ABOARD OF PUBLIC WORK
AGENDA ITEM REVIEW REQUEST FORM
I1.
Name Kyle Silveus Department Engineering__
BPW Date 08/14/2018 Phone Extension 9083
Required Prior to Submittal to Board
Legal ❑ Attorney Name Clara McDaniels
Controller Ei 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 Michael Schmiidt
Check the Appropriate Item Type — RequJiredd for All Submissions
F-1 Agreement
El Contract E] Proposal ❑ Addendum
El Professional Services
R Resolution
El Bid Opening
El Bid Award Req. to Advertise F-1 Title Sheet
El Quote Opening
El Quote Award
R Change Order No.
F1 C/O & P,CA No. ❑ PGA
F-1 Ease/Encroach.
❑ Traffic Control
F-1 Other:
Required Information
Company or Vendor Name
TBD
New Vendor
El Yes 0 No F-1 If Yes, Approved by Purchasing
MBEANBE Contractor
[:] MBE F-1 WBE
MBE/WBE Contractor Requested E:1 No F-1 Yes Name of Company
Project Name
Gemini Washington -Colfax Apartment Improvements�
Project Number
118-08 OA
Funding Source
West Washington TIF
Account No.
Amount
$ TBD
Terms of Contract
Base bid
Purpose/Description
Repair of Apartment Building Roof 1 along' ashington St.
Required Contractor's Certification Form Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verif , Iran, etc.)
Required For�Chan `e OrdersnI...
Amount of F11 increase $
F-1 Decrease $
Previous Amount
-'*Ar&
Current Percent of Change:
% IDT J?UJ6Ji,. W,,
New Amount
$
Total Percent of Change:
%
Dispersal After Approval
Copy Original I
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