HomeMy WebLinkAboutRequest to Advertise - Muessel Grove Public Restroom Project No 118-099RBOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 08/29/19
Name Alicia Czarnecki Department Engineering
BPW Date 09/10/19 Phone Extension 5903 ......
HIM
lrtl Prior to Submittal to Board
_.._�.....N _.....
BPW Attorney Attorney Name
Dept. Attorney Attorney Name
Purchasing R
Check the Appropriate Itern ly
Professional Services Agreement F Contract
Open Market Contract ❑ Amendment/Addendum
Bid Opening ❑ Bid Award
Quote Opening ❑ Quote Award
E] Proposal Opening F-1 C/O & PCA No.
E] Chg. Order, No. Traffic Control
0 Other:
Company or Vendor Name
New Vendor
MBE/WBE Contractor
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Amount of ❑
❑
Previous Amount
Current Percent of Change:
New Amount
Information
All Submissions
L j Proposal
[� Special Purchase, QPA
® Req. to Advertise
�❑❑ Reject Bids/Quotes
[� PCA
] Resolution
[] Ease./Encroach
❑ Title Sheet
Yes If Yes, Approved by Purchasing
❑� No
MBE Completed E-Verify Form Attached El Yes
WBE ❑ No
Muessel Grove Public Restroom
. ... �...._...... w
VPA Capital
416.0404.453.36.01
Public Restroom renovation at Muessel Grove Park to restore functipnglJly
and meet all applicable state and federal code re Uirements.
Increase $ �.. ..
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Decrease ___.......... is or.
_-
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$....................... _ ... .w_
Increase %
Decrease %) 4M ...,..
$ AI
Increase %
Total Percent of Change: Decrease ( %
Time Extension Amount: _.
New Completion Date: