HomeMy WebLinkAboutRequest to Advertise - Pulaski Park Improvements Project No 118-056BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 05/17/2019
Name _��e Si!veus Department Enaineerin
BPW Date 05/14/2019 Phone Extension 9083
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.......................
. ......... . . ..i ................ . ...... Required Prior Prior to Submittal to Board
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Legal El Attorney Name Clara McDaniels
Controller El 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 F-1 Michael Schmidt
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Check the
EJ Agreement
El Professional Services
0 Bid Opening
El Quote Opening
F1 Change Order No.
E] Ease/Encroach.
E] Other:
)Mrqqu e Item Type - Req�
El Contract
El Resolution
F-1 Bid Award
El Quote Award
El C/O & PCA No.
El Traffic Control
Company or Vendor Name TBD
for All Submissions
Proposal Ad—dendu.-m.
Z Req. to Advertise Z Title Sheet
ired Information
El PCA
New Vendor
E] Yes n No E] If Yes, Approved by Purchasing
MBE/WBE Contractor
n MBE F-1 WBE
MBENVBE Contractor Requested [:] No F-1 Yes Name of Company
Project Name
Pulaski Park Improvements
Project Number
118-056
Funding Source
TIF on
Account No.
452-1101-452.31-06
Amount
N/A
Terms of Contract
Base Bid plus Alternates
Purpose/Description
Pulaski Park Improvements
0 Required Contractor's Certification Form Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verifv, Iran, etc.
Amount of
Required For Chafe Orders 09)y
Increase
. ....................
Decrease IVAL,
Previous Amount $
Current Percent of Change: %
- - — - - -----
New Amount
. . . . . ....................
Total Percent of Change: %
Dispersal After Approval
Copy Original
F-1 F-1
F-1 F-1 - -------------------
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