HomeMy WebLinkAboutRequest to Advertise & Title Sheet - 3400 Block S. Michigan Street Improvements Proj No. 120-062BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 1/19/2021
Name Charlotte Brach
Department
Engineering
BPW Date 1/26/2021 Phone Extension 9246
Review and Approval Required Prior to Submittal to Board
Diversity Compliance
and Inclusion Officer Officer Name
BPW Attorney Attorney Name
Dept. Attorney Attorney Name
Purchasing
Check the Appropriate Item Type – Required for All Submissions
Professional Services Agreement Contract Proposal
Open Market Contract Amendment/Addendum Special Purchase, QPA
Bid Opening Bid Award Req. to Advertise Title Sheet
Quote Opening Quote Award Reject Bids/Quotes
Proposal Opening C/O & PCA No. PCA
Chg. Order, No. Traffic Control Resolution
Other: Ease./Encroach
Required Information
Company or Vendor Name
New Vendor Yes If Yes, Approved by Purchasing
No
MBE/WBE Contractor MBE
WBE Completed E-Verify Form Attached Yes
No
Project Name 120-062 3400 Block S Michigan Streetscape Improvements
Project Number PROJ00000216
Funding Source TIF – Southside Development #1
Account No. 430-10-102-121-442001-PROJ00000216
Amount
Terms of Contract
Purpose/Description Request to advertise for the receipt of bids for streetscape improvements for
the 3400 block of S Michigan Street.
For Change Orders Only
Amount of Increase
Decrease
$
($ )
Previous Amount $
Current Percent of Change:
Increase
Decrease
%
( %)
New Amount $
Total Percent of Change:
Increase
Decrease
%
( %)
Time Extension Amount:
New Completion Date: