HomeMy WebLinkAboutRequest to Advertise - Small Drainage Design and Repair - Project No 118-063BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 11 /06/18
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Name � S.u... E �...�_____w.
e Ellen Doudrick
Department Public . Works
......... ..........__. _
Division/Bureau Engineering
BPW Date 11/13/18 Phone Extension 5922
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Rewired Prior to Submittal to Board
Legal Attorney 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 the.Anro riate Item Tvngm — Paryid orl for All Submissions
Agreement Amendment
Professional Services
Bid Opening
Quote Opening
Change Order No.
Ease/Encroach.
Other:
Company or Vendor Name
Contract
El Resolution
Bid Award
❑ Quote Award
❑ C/O &PCANo
n Traffic Control:
New Vendor
MBE/WBE Contractor
MBE/WBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Proposal
® Req. to Advertise
uired Information
❑ PCA
Addendum
® Title Sheet
Small Drainage Improvements to 1) Olivia Circle 2) Creekwood
_ r Hawbaker Street
Purpose/Description Estates ... ..._ . �...
._..... q d Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
,...... ._.... m _._.._ -
Reouired For Chae Orders Only
$
Amount of - Increase .. ........ .................... �d f
Decrease $
m ........_ ... w� ��
Previous Amount $
Current Percent of Change:
New Amount .. ..
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Total Percent o Change:
Dt�eral After.�?�°�a�l!
Copy Original
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® Kara Boyles
® El Sue Ellen Doudrick...�.................................�.�.�.�_�.�_................_. �...�.............................................._�mm.......w �.��..