HomeMy WebLinkAboutRequest to Advertise - J.C. Lauber Site Improvements Project No 118-083BDate
Name
Ham
Kyle Silveus
BOARD OF PUBLIC WORDS
AGENDA ITEM REVIEW REQUEST FORM
Department
Division/Bureau
FRIMMIMPAIM
Engineering
BPW Date 8/28/201,8 Phone Extension 9083
Required Prior to Submittal to Board
Legal F] Attorney Name: Clara McDaniels
Controller El 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 Tvpe — Required forAll Submissions
❑ Agreement
F Contract E] Proposal ❑ Addendum
F-1 Professional Services
F-1
Resolution
F Bid Opening
El
Bid Award Z Req. to Advertise ❑ Title Sheet
F-1 Quote Opening
F-1 Quote Award
E]
Change Order No.
F-1 C/O & PCA No. F-1 PCA
F-1
Ease/Encroach.
F-1 Traffic Control:
El Other.-
Required Information
Company or Vendor Name NIA
New Vendor 0 Yes El No 0 If Yes, Approved by Purchasing
MBE/WBE Contractor MBE 0 WBE
MBEANBE Contractor Requested F-1 No [:] Yes Name of Company
Project Name J.C. Lauber Site Improvements
Project Number 118-083 B
Funding Source RIVER EAST' DEVELOPMENT TIF
Account No. 429-11050-460-42.0,3
Amount N/A
Terms of Contract Base plus alternates
Purpose/Description Parking lot installation, underground stormwater retention, and
misc. sidewalk improvements
R Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
'Required For Chan e Orders ',Only,
Amount of F-1 increase $
El Decrease, $ APPROV11)
fteard or 5—
Previous Amount $
Current Percent of Change
New Amount
Total Percent of Change:
Dispersal After Approval
Copy
Original
1:1
R
F-1
F]
El
1:1