Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 08/29/19 <br />Name Alicia Czarnecki Department Engineering <br />BPW Date 09/10/19 Phone Extension 5903 ...... <br />HIM <br />lrtl Prior to Submittal to Board <br />_.._�.....N _..... <br />BPW Attorney Attorney Name <br />Dept. Attorney Attorney Name <br />Purchasing R <br />Check the Appropriate Itern ly <br />Professional Services Agreement F Contract <br />Open Market Contract ❑ Amendment/Addendum <br />Bid Opening ❑ Bid Award <br />Quote Opening ❑ Quote Award <br />E] Proposal Opening F-1 C/O & PCA No. <br />E] Chg. Order, No. Traffic Control <br />0 Other: <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of ❑ <br />❑ <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Information <br />All Submissions <br />L j Proposal <br />[� Special Purchase, QPA <br />® Req. to Advertise <br />�❑❑ Reject Bids/Quotes <br />[� PCA <br />] Resolution <br />[] Ease./Encroach <br />❑ Title Sheet <br />Yes If Yes, Approved by Purchasing <br />❑� No <br />MBE Completed E-Verify Form Attached El Yes <br />WBE ❑ No <br />Muessel Grove Public Restroom <br />. ... �...._...... w <br />VPA Capital <br />416.0404.453.36.01 <br />Public Restroom renovation at Muessel Grove Park to restore functipnglJly <br />and meet all applicable state and federal code re Uirements. <br />Increase $ �.. .. <br />.��....._... .............m_ . �... ._. _._..._a a - .._ <br />Decrease ___.......... is or. <br />_- <br />� <br />$....................... _ ... .w_ <br />Increase % <br />Decrease %) 4M ...,.. <br />$ AI <br />Increase % <br />Total Percent of Change: Decrease ( % <br />Time Extension Amount: _. <br />New Completion Date: <br />