HomeMy WebLinkAboutRequest to Advertise - VPA Restroom Remodeling - Project No 118-043BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date,
September 17, 2018
Department
Public Works
Name
Scott Kreeger--. . . ......
Division/Bureau
--Engineering
BPW Date
September 25, 2018
Phone Extension
9�245
Required Prior to Submittal to Board
Legal 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 Z Michael Schmidt
Check the Appropriate Item Type - Required for All Submissions
Agreement Amendment [:] Contract El Proposal El Addendum
❑ Professional Services F-1 Resolution
Fj Bid Opening F-1 Bid Award Z Req. to Advertise [ATitle Sheet
F-1 Quote Opening F-1 Quote Award
[:1 Change Order No. El C/O & PCA No. ❑ PCA
El Ease/Encroach. ❑ Traffic Control:
El Other.
-
Reauired Information
New Vendor
MBEANBE Contractor
MBE/BE Contractor Requested
Project Name
Project Number
Funding Source
Account No,.
Amount
Terms of Contract
Purpose/Description
[::] Yes El No F-1 If Yes, Approved by
Purchasina
MBE Ll WBE
No F-1 Yes Name of Co
VPA Restroom Remodeling
118-043
471-1138-452.42-01
Parks Bond I
Request to Advertise on September 28th and October 5th
" Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
Required For Change Orders Only
Amount of F-1 increase $
F-1 Decrease$
Previous Amount
Current Percent of Change: %
New Amount $ nNoirks
Total Percent of Change: %
Dispersal After Approval
Copy Original
z El Patrick Sherman, Project Manager
z ❑ Kara Boyles
z F-1