HomeMy WebLinkAboutRequest to Advertise & Title Sheet - 2021 Drainage Improvements Proj No. 121-006ABOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 07/16/2021
Name Becca Plantz Department Public Works
BPW Date 07/27/2021 Phone Extension 5998
Review and Approval Required Prior to Submittal to Board
Diversity Compliance
and Inclusion Officer Officer Name Michael Patton
BPW Attorney Attorney Name Clara McDaniels
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 2021 Drainage Improvements – Kaley St & Marion St
Project Number 121-006A
Funding Source Stormwater Infrastructure-Sewers
Account No. PR-000010684
Amount
Terms of Contract Unit Prices & Lump Sums
Purpose/Description Small drainage improvements to Kaley Street and Marion Street including
site preparation and sewer line improvements.
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:
7/15/202107/16/20217/16/20217/16/2021