HomeMy WebLinkAboutRequest to Advertise - Mishawaka Ave Traffic Signals at Fire Station No 9 Project No 117-120ABOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date January 14, 2019
Name Roger Nawrot
Department Public Works
Division/Bureau Engineering
BPW Date January 22, 2019 Phone Extension 5932
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Re wired 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 ❑
Check the w
LAgreement
Professional Services
Bid Opening
❑ Quote Opening
El Change Order No.
Ease/Encroach.
Other:
Michael Schmidt
)riate Item Ty..:-
Contract
Resolution
for All Submissions
I Proposal
Bid Award ® Req. to Advertise
❑ Quote Award
❑ C/O & PCA No. ❑ PCA
❑ Traffic Control:
Company or Vendor Name
New Vendor
MBE/WBE Contractor
MBE/WBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Required Information
Yes LJ No MBE �_ VVBEWW�� If Yes Approved
-Name of Comoanv
Addendum
® Title Sheet
Purchasi
Mishawaka Avenue.T
Traffic Si nals at Fire Station No. 9
..........................!.._......_. �.
117-120A
Terms of Contract _ ..........ww.
Purpose/Description The project is to be advertised on January 25 and February 1
with bids opened on February m 12 Toy has the Title Sheet,
E] Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
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meuiange Orders red For ChOnl
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Amount of El Increase $
El Decrease $
Previous Amount � ................ � it �I�
Current Percent of Change: % tf .....
New Amount
Total Percent of Changmmm .. w %
Dismersal After Aooroval
Copy Original-�
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