HomeMy WebLinkAboutRequest to Advertise - Sewer and Manhole Rehabilitation - Project No 118-093BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 11/6/18
Department Public Works
Name Sue Ellen Doudrick Division/Bureau Engineering
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BPW Date 11/13/18 Phone Extension 5992
Required Prior to Submittal to Board
LegalAttorney
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 them
Hate Item "hype — Requiredfor All Submissions
Agreement Amendment
FC
ontract �Proposal Addendum
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Professional Services
n
Resolution
El
Bid Opening
n
Bid Award ® Req. to Advertise ❑ Title Sheet
❑ Quote Opening
❑
Quote Award
❑ Change Order No.
❑
C/O & PCA No. ❑ PCA
❑
Ease/Encroach.
❑
Traffic Control:
n
Other:
Company or Vendor Name
New Vendor
MBE/WBE Contractor
MBE/WBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Amount of
Increase
Decrease
Previous Amount
Current Percent of Change:
New Amount
Total Percent of Chanae:
Copy
Original
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red Information
Yes No ❑mmmmlf Yes, Approved by
Purchasin
MBE WBE
....
Yes Name m
No of Companwy�
Sewer and Manhole Rehabilitation
118-093 .................. ____ Y .�.............
.
Utilitv Expense/Contractual Service
641-0621-792.63-35
Sewer & Manhole Rehabilitation for 1) CSO 018 Network from
Dale to River, 2) Diamond/Angela from Lincoln Way to River, 3)
and other various sewer and manhole locations
Required Contractor's Certification Forms At q � tached (Non
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
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uired For Orders Chan e OrdeOnl"'
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