Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />29 June 2018 <br />Department <br />Public Works <br />Name <br />Amy Kryston <br />Division/Bureau <br />Engineering <br />BPW Date <br />10 July 2018 <br />Phone Extension <br />9246 <br />Legal Attorney Name: <br />Controller Controller review is required for all Contracts $5,0:00,00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing <br />H Agreement Amendment <br />E] Professional Services <br />0 Bid Opening <br />F1 Quote Opening <br />El Change Order No. <br />El Ease/Encroach. <br />F-1 Other: <br />Company or Vendor Name <br />H Contract L] Proposal H Addendum <br />F-1 Resolution <br />El Bid Award Req. to Advertise El Title Sheet <br />F] Quote Award <br />F-1 C/O & PCA No. E] PCA <br />F-1 Traffic Control: <br />New Vendor <br />MBE/WBE Contractor <br />MBEANBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />El Yes E] No El If Yes, Approved by <br />Purchasing <br />[:] MBE [-] WBE <br />0 No El Yes Name of Company <br />118-070 <br />2018 Street Paving <br />Building & Street Maintenance <br />202-0607-431,36-01 <br />Request to Advertise on 13 July and 20 July, 2018 <br />E] Required Contractor's Certification Forms Attached (Non- <br />Coflusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Amount of LJ <br />Increase $ <br />El: <br />Decrease $ U*Xrd of Pah& Ivor <br />Previous Amount <br />$ <br />Current Percent of Change: % <br />New Amount <br />$ <br />Total Percent of Change: <br />% <br />Dispersal After Approval <br />Copy Original <br />M F-1 <br />Sue Ellen Doudrick <br />M RI <br />Kara Boyles <br />z F-1 <br />Roger Nawrot <br />z <br />Scott Kreeger <br />z F-1 <br />Amy Kryston <br />0 El <br />