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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 01/26/2017 <br />Name Richard Estes <br />Department <br />Division/Bureau <br />Public Works <br />Engineering <br />BPW Date 02/14/2017 Phone Extension 5896 <br />Required Prior to Submittal to Board <br />Legal ® Attorney Name: Michael Schmidt <br />Controller ❑ Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing ® George King <br />Check the Appropriate Item Type — Required for All Submissions <br />❑ Agreement ❑ Contract ❑ Proposal ❑ Addendum <br />❑ Professional Services ❑ Resolution <br />❑ Bid Opening ❑ Bid Award ® Req. to Advertise ® Title Sheet <br />❑ Quote Opening ❑ Quote Award <br />❑ Change Order No. ❑ C/O & PCA No. ❑ PCA <br />❑ Ease/Encroach. ❑ Traffic Control: <br />F-1 Other: <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />MBE/WBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of <br />Increase <br />Decre; <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />REDA TIF <br />429-1050-460-42.02 <br />Repair of the Newman Center Windows and Doors. Proposed <br />schedule: Ad1-2/17, Ad2-2/24, Bids Due 3/7, Bid Award 3/7 <br />H Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />After <br />Copy Original <br />® ❑ Patrick C Kerr <br />® ❑ Aaron Kobb <br />❑ ❑ <br />Orders O <br />