HomeMy WebLinkAboutRequest to Advertise - 2019 Curb and Sidewalk Construction Project No 119-004BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 04/02/19
Name Alicia Czarnecki Department En ineearin
BPW Date 04/09/19 Phone Extension 5903
MM
l aired Prior to Submittal to Board
BPW Attorney ® Attorney Name
Dept. Attorney ® Attorney Name
_._M .....WW
Purchasing z
Check the AppropriateItemType — Recj
L] Professional Services Agreement F] Contract
E]
Open Market Contract
n
Amendment/Addendum
[:]
Bid Opening
❑
Bid Award
[l
Quote Opening
❑
Quote Award
n
Proposal Opening
[ ]
C/O & PCA No.
❑'
Chg. Order, No.
F-1
Traffic Control
F Other:
Reauirod Information
All Submissions
Proposal
Special Purchase, QPA
® Req. to Advertise
E] Reject Bids/Quotes
E] PCA
Resolution
Ease./Encroach
❑ Title Sheet
Company or Vendor Name
New Vendor YesEJ If Yes, Approved by Purchasing
❑ No
MBE/WBE Contractor MBE Completed E-Verify Form Attached ❑ Nos
Project Name 2019 Curb & Sidewalk iq
Project Number 119-004
Funding Source MVH
�... _._._._._. ............... .-.._ .......
Account No. 202-0619-431.31-06
Amount ..........................
Terms of Contract
................................. ..----
Purpose/Description
��..
For Clit
.......n. E_ Orccrs Only
�..�
Amountof ❑
Increase $
.........
t cl Alwila '%' k�i
........ .._ ...............
❑
Decrease ($
Previous Amount
_ITITITITITITmm
' OE
Increase
%
Current Percent of Change:
Decrease
( %)
»a
New Amount
Increase
%
............... ._ .........................
Total Percent of Change:
Decrease
( %)
Time Extension Amount:
New Com letion Date:
...._..........___.._