HomeMy WebLinkAboutRequest to Advertise - McKinley Avenue and Fremont Park Improvements - Project No 118-072BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 11/06/2018
Aida za n......._S.0 n Doudrick Department Engineering
Name Alicia Czarnecki/Sue Ellen
BPW Date 11/13/2018 Phone Extension 5903
......
_�..�....�............ Legal ..
Fquired Prior to Submittal to Board _
® Attorney Name Clara McDaniels _...m................
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
Check the—,
Agreement
El Professional Services
Bid Opening
❑ Quote Opening
Change Order No.
El Ease/Encroach.
n Other:
Michael Schmidt
Item Tvoe —
" Contract
Resolution
El Bid Award
Quote Award
❑ C/O & PCA No.
® Traffic Control
Company or Vendor Name TBD
r All Submissions
Proposal
® Req. to Advertise
uired Information
❑ PCA
New Vendor ❑ Yes ® No ❑ If Yes, Approved by Purchasing
MBE/WBE Contractor ❑ MBE ❑ WBE
MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company
Project Name McKinlet' Avenue and Fremont Park Improvements
Project Number 118-072
Addendum
® Title Sheet
LRSA Utility Expense Contractual Service Fund / VPA (max
Funding Source $25q,000w00 � ...,. �a ��...�....... ......�.�.....,m
Account No. 251.0608.431.4.................
Amount TBD
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Terms of Contract TBD
Purpose/Description
❑ Required Contractor's Certification Form Attached (Non -
Collusion, on -Discrimination„ Non Debarment, , Iran„ etch
Required For Charue Orders O� _...
Amount of
El increase
F] Decrease
t
Previous Amount $
............ .................
Current Percent of Change:
New Amount
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Total Percent of Change: % �~
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Dispersal After Approval
Copy Original
® ❑ Kara Boyles
❑
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