HomeMy WebLinkAboutTitle Sheet - Prairie Ave. (SR 23) Water Main Extension - Proj No. DP 18-025 - Star 001, LLC.BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 2/18/2020..__................ _..... w
Department
Name _......_.........Sue Ellen Doudrick_..... __.. ._.......... .....
Engineering
BPW Date 2/25/2020 Phone Extension 5922
�.__...._....... ___._._w .... _....... _...........
E ..... m .._w „w RNuired. Prior to Submittal to Board
_........ ........_.
BPW Attorney Attorney Name Clara McDaniels
Dept. Attorney F Attorney Name
Purchasing [� ...__.�...._...._.......� .....__........
_...................._._................. Check the.. Appropriate Item 'I y.p`-:...._
❑ Professional Services Agreement n Contract
[-1 Open Market Contract n Amendment/Addendum
Bid Opening Bid Award
�] Quote Opening ❑ Quote Award
Proposal Opening ❑ C/O & PCA No.
❑ Chg. Order, No. ❑ Traffic Control
❑ Other:
Company or Vendor Name
New Vendor
MBE/WBE Contractor
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
bi All Submission
[:] Proposal
❑ Special Purchase, QPA
Req. to Advertise
Reject Bids/Quotes
[� PCA
Resolution
Ease./Encroach
Star 001, LLC
YesEJ
If Yes �...A.............__..._. Purchasi__...................._.�
Approved by ng
❑ No
❑ MBE Completed E-Verify Form Attached
❑ WBE
__� ) ..Extension
Prairie Avenue SR 23 Water Mai
DP 18-025
n/a
® Title Sheet
❑ Yes
❑ No
Purpose/Description Title Sheet for the construction of a public water main extension to serve the
Star 001 development. Water main to extend from the Four Winds Casino si
to Star 001.
For C, ian e Orders Only
Increase
Amount of $
Decrease
Previous Amount $
Increase %
Current Percent of Change: Decrease ( % _ ......
New Amount
Increase
....� �._-------------
.
Total Percent of Change: Decrease /o)
0
Time Extension Amount:
New Completion Date. .......