PCA - Martin Luther King Jr Center HVAC Revisions Proj No 116-064 - Hermann & Goetz Inc.

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date January 31, 2017 Department Public Works Name Toy Villa � , Division/Bureau Engineering BPW Date February 14, 2017 Phone Extension 5920 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: ❑ Other: Required Information 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 Amount of Herrman & Goetz, Inc. ❑ Yes ® No ❑ If Yes, Approved by Purchasing? ❑ MBE ❑ WBE ❑ No ❑ Yes Name of Company Martin Luther King Jr. Center HVAC Revisions 116-064 Parks Bond Improvement Allocation Fund $379,708.00 Renovation and Replacement of HVAC units and equipment Project Closeout ❑ Required Contractor's Certification Forms Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc. Reauired For Chanae Orders Only Increase Decrease Previous Amount Current Percent of Change New Amount Total Percent of Chanae: Copy Original ® ❑ ® ❑ ❑ ❑ Aaron Perri — Parks & Recreation John Martinez — Parks & Recreation