HomeMy WebLinkAboutRTA & Title Sheet - 2024 Curb and Sidewalk Program Proj No. 124-009BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date: 6/6/2024
Name: Gemma Stanton Department of Public Works – Engineering Division
BPW Date: 6/11/2024 Phone Extension: 9083
Required Prior to Submittal to Board
BPW Attorney X 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 2024 Curb and Sidewalk Program
Project Number 124-009
Funding Source Motor Vehicle Highway
Account No.
Amount
Terms of Contract Unit price
Special Contract Provisions N/A
Purpose/Description Request to advertise for the receipt of bids on 2024 Curb and Sidewalk
Program and sign project title sheet
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:
Div1-PR-33969 Div2-PR-34020 Div3-PR-34021 Div4-34021
Div4-PR-33022 Div5-PR-34029
June 11, 2024
6/3/2024
6/2/2024
6/4/2024
6/4/2024
June 11, 2024