HomeMy WebLinkAboutRequest to Advertise - Lafayette Building Skylight & Masonry Repairs Project No 117-100RBOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date September 4, 2018
Name Kyle Silyeus Department —Engineering
BPW Date Septerrrber 11, 2018 Phone Extension 9083
Required Prior to Submittal to Board
Legal ❑ Attorney Name
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 El
Check the Appropriate Item Type — Required for ill Subrraissions
[:1 Agreement El Contract El Proposal ❑ Addendum
F-1 Professional Services n Resolution
F-1 Bid Opening n Bid Award Z Req. to Advertise Title Sheet
F] Quote Opening ❑ Quote Award
F] Change Order No. ❑ C/O & PCA No. F1 PCA
E] Ease/Encroach, Traffic Control
F-1 Other:
Company or Vendor Name
New Vendor
MBEANBE Contractor
Project Name
Project Number
Funding Source
Account No.
Amount
uired Information
TBD
Yes [:1 No ❑ If Yes, Approved by Purchasing
MBE [_1 WBE
Lafayette Building Skylight & Masonry Repairs
117-IOOR
RWDA
324-1050-460-42,02
$ TBD
Terms of Contract Base Bid plus Alternates
Purpose/Description Skylight and Masonry Repairs to Lafayette Building
F-1 Required Contractor's Certification Form Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, iran, etc.,--.
Required For Chanqe Orders Only
Amount of R increase $
El Decrease $
Previous Amount $
Current Percent of Change: %
New Amount $
Total Percent of Change: % AY VID
Behad ?5f
Dispersal After Approval
Copy
Original
1:1
n
F-1
F1
1:1
El