HomeMy WebLinkAboutRequest to Advertise - Southeast Park Playground Resurfacing Proj No. 123-043BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 05/02/2023
Name Patrick Sherman Department Public Works
BPW Date 05/09/2023 Phone Extension
Review and Approval Required Prior to Submittal to Board
Diversity Compliance
and Inclusion Officer Officer Name
BPW Attorney Attorney Name Michael Schmidt
Dept. Attorney Attorney Name
Purchasing Mickey Lovey
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 TBD
New Vendor Yes If Yes, Approved by Purchasing
No
MBE/WBE Contractor MBE
WBE Completed E-Verify Form Attached Yes
No
Project Name Southeast Park Playground Resurfacing
Project Number 123-043
Funding Source
Account No.
Amount TBD
Terms of Contract Unit Price
Purpose/Description _Remove and replace poured in place playground surfacing at Southeast
Park.__________________________________________________________
__________________________________________
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:
May 9, 2023