HomeMy WebLinkAboutRequest to Advertise - Gemini Site Improvements Project No 119-043ABOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date
Name
4/16/19
e Silveus
Department Engineering
BPW Date 4/23/19 Phone Extension 9083
_...... ................ ._.._
Required 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 Appropriate Item Tpe —
LJ, Agreement
E Professional Services
F_J Bid Opening
El Quote Opening
Change Order No. _
El Ease/Encroach.
Other:
LJ Contract
E] Resolution
E' Bid Award
❑ Quote Award
❑ C/O & PCA No.
Traffic Control
d for All Submissions _
Proposal ❑Addendum
® Req. to Advertise ❑ Title Sheet
ired Information
Company or Vendor Name TBD
New Vendor Yes ❑ No [
MBE/WBE Contractor MBE ❑ WBE
MBE/WBE Contractor Requested ❑ No ❑ Yes
Project Name Gemini Site Imf
Project Number 119-043A
❑ PCA
If Yes, Approved by Purchasing
Name of Company
rovements
Funding Source West Washington TIF
Account No. 422-1050-460-42.02
Amount......�....T�B.D...._ �.....� �..........��_�W �,�............�����..�... ..���...�.......
�mm_ m.......... �W __ ... ....�.. - - - A. ..... ...
Terms of Contract Base bid
Purpose/Description Parki
ng and Draina a Im p rovements to Gemini A a_
rtrent _Qom lex
south of Colfax
❑ Required Contractor's Certification Form Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify,Iran etc.)._.........
Required For Chan a Orders wOnly
El crease $ °, *�tl
Amount of �.._ .. �..r f" � � �- _..
El Decrease $
Previous Amount $
Current Percent of Change 0/0 �j t
New Amount
Total Percent of Change: %
Dispersal After Approval
Copy Original
❑ ❑,.