HomeMy WebLinkAboutRequest to Advertise - Western Ave Streetscape Phase III Project No 118-076BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 4/17/19 Department Public Works
Name Kyle Silveus �_..._ Division/Bureau Engineering
______.........................._W.............._._._..._.
BPW Date 4/23/19_ �_._...._._....._.
Phone Extension 9083
m99 mmmmmmmmmuuuuuuuuuuuuuuumuwuuuuuuuuuuuuuuuuuum winmw�.uawwnm
Reauired 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 ❑ Michael Schmidt
Check the
LJ Agreement
❑ Professional Services
❑ Bid Opening
El Quote Opening
F� Change Order No. _
E Ease/Encroach.
I Other:
rro� Item Type -
Contract
Resolution
Bid Award
Quote Award
C/O &PCANo.
❑ Traffic Control:
Company or Vendor Name
New Vendor
MBE/WBE Contractor
MBE/WBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
for All Submissions
I Proposal
® Req. to Advertise
aired Information
❑ PCA
Addendum
Title Sheet
Terms of Contract Lump Sum v.. _m
Purpose/Description Base Bid
Required Contractors Certification s Attached
' Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
Required For Change Orders Only
Amount of El Increase $
El Decrease $
Previous Amount $u
.............
Current Percent of Change: ,%
New Amount $
Total Percent of Change: % �.,.,.
�.................�w_ Dispersal After Approvals A ..... .......I
Copy
Original