Request to Advertise - Drewery's Brewery Cleanup Project No 119-031A

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date Name 3/29/19 le Silveus Department Enineerin� BPW Date 4/9/19 Phone Extension 9083 mmi mimmm00000000mmmmmmw�mmmummmmuwwwwwwr�w yw,mmirmm®m�rmrrr��u�ouuuuuuuummummmmmmmmmmwnr n�www�w�mww.�omomomo�mww�w�o!r � � �g� -.. ..._... ...._........ ................ ...._... ,R�tquired Prior to Submittal to Board .... .._....... Legal Attorney Name Clara McDaniels Controller Controller review is required for all Contracts $5,000.00 or more anc greater than one year in length per the City Purchasing Policy Purchasing ❑ Michael Schmidt Check the Agreement Professional Services ❑ Bid Opening ❑ Quote Opening I1 Change Order No. Ease/Encroach. El Other_ Company or Vendor Name �ropr±ate Item 'Type -.. ❑ Contract ❑ Resolution El Bid Award R Quote Award ElC/O &PCANo. _ R Traffic Control for All Submissions Proposal Addendum ® Req. to Advertise ❑ Title Sheet red Information ❑ PCA New Vendor ❑ Yes El No 0 If Yes, Approved by Purchasing MBENVBE Contractor ❑ MBE WBE MBEM/BE Contractor Requested ❑ No ❑ Yes Name of Company Project Name Drewery's Brewery Cleanup ..m Project Number 119-031A Funding Source RWDA, Consolidated Building Fund........... Account No. 324-1050-460-39.82 Amount $ N/A Terms of Contract Purpose/Description ❑ Required Contractor's Certification Form Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc. R d For Change Orders,p, l Amount of Increase $ Decrease $ Previous Amount $ _..._. _.�........ ..... �r. Current Percent of Change: % � ��•�_ New Amount ... _ Total Percent of Change: % Copy Original . Dispersal After Approve ❑ m ..... _..... wwv ......_ .. . ❑ ❑