HomeMy WebLinkAboutRequest to Advertise - MLK Jr Center HVAC Revisions - 116-064Date 07/12/2016
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Department Public Works
Name
Nadia Correa
Division/Bureau
Engineering
BPW Date
7/12/2016
Phone Extension
5796
Required Prior to Submittal to Board
Legal ® Attorney Name: Michael Schmidt
Controller ❑ Controller review is required for all Contracts $5,000.00 or more and
greater than one year in length per the City Purchasing Policy
Purchasing ® George King
Check the Appropriate Item Type — Required for All Submissions
❑
Agreement
❑ Contract ❑ Proposal ❑ Addendum
❑
Professional Services
❑ Resolution
❑
Bid Opening
❑ Bid Award ® Req. to Advertise ❑ Title Sheet
❑
Quote Opening
❑ Quote Award
❑
Change Order No.
❑ C/O & PCA No. ❑ PCA
❑
Ease/Encroach.
❑ Traffic Control:
I-1
Other:
Company or Vendor Name
New Vendor
MBE/WBE Contractor
MBE/WBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
❑ Yes ® No ❑ If Yes, Approved by
"MBE U WBE
No ❑ Yes Name of Compan
Martin Luther King, Jr. Center HVAC Revisions
116-064
Parks Bond
LJ Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
Change Orders
Amount of
Increase
Previous Amount $
Current Percent of Change: %
New Amount $
Total Percent of Change: %
After
py
Original
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