HomeMy WebLinkAboutRequest to Advertise - Main and Jefferson Earthwork Project No 119-022BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 2/19/19 Department Public Works
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Name Kyle Silveus Division/Bureau Engineering
Check the Appropriate Item Type — Re wired for All Submissions
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Agreement
❑ Contract Proposal El Addendum
Professional Services
❑ Resolution
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Bid Opening
0 Bid Award ® Req. to Advertise ® Title Sheet
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Quote Opening
El Quote Award
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Change Order No.
C/O & PCA No. ❑ PCA
Ease/Encroach.
Traffic Control:
M Other:
Company or Vendor Name
New Vendor
MBE/WBE Contractor
MBE/WBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
TBD
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❑❑ Yes 1 No If Yes, �
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MBE E] WBE
No ❑ Yes Name of C...-_.....
o
Main and Jefferson Earthwork
119-022
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RWDA TIF
324-1050-460.42-01
TBD
by Purchasi
Terms of Contract TBD
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Purpose/Description Base Bid
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Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
p re For Chan a Orders gLn
Amount of Increase $
�] Decrease $
Previous Amount _ ._..
Current Percent of Change:
New Amount
Total Percent of Chanae:
Discersal After
Copy
Original
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