HomeMy WebLinkAboutRequest to Advertise - Lincoln Way East Corridor Improvements, Phase 1 - Proj No 117-055ABOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date
8/7/18
Department
Public Works
Name
Kyle Silveus
Division/Bureau
Engineering
BPW Date
8/14/2018
Phone Extension
9083
1-0 I I 1 "10 H I me - a M0 Kq re ra I M MI "If
Legal F1 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 ❑ Michael Schmidt
Check the
LJ Agreement
F-1 Professional Services
0 Bid Opening
F-1 Quote Opening
[:] Change Order No.
El Ease/Encroach.
F1 Other:
TqpiaLeItem Type�
F-1 Contract
El Resolution
El Bid Award
F-1 Quote Award
[:1 C/O & PCA No.
F-1 Traffic Control:
Company or Vendor Name
New Vendor
MBEANBE Contractor
MBENVBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
uired Information
10 F1.111
for All Submissions
I Proposal
INIM
Addendum
0 Title Sheet
01 Yes El No 0 If Yes, Approved by Purchasing
[:] MBE [:] WBE
_E] NoEl Yes Name of Company
Lincoln Way East Corridor Improvements - Phase I
117-055A
RWDA TIF
324-1050-460-31-02
$TBD
Base Bid
Purpose/Description Phase 1 Construction
F-1 Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non-Debarmenit, E-Verify, lran, etc.)
Required For Change Orders Only
Amount of F-1 increase $
[:] Decrease $ A.PL)
Previous Amount $ B"ard Of Pull Work,4
Current Percent of Change: %
New Amount
Total Percent of Chance:
Dispersal After Amroval
Copy Original
F] 1-1
0