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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />02/20/2018 <br />Department <br />Public Works <br />Name <br />Toy Villa <br />Division/Bureau <br />Engineering <br />BPW Date <br />02/27/20118 <br />Phone Extension <br />5920 <br />Legal ❑ Attorney Name: <br />Controller ❑ Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing El <br />LJ Agreement <br />El Professional Services <br />F-1 Bid Opening <br />F-1 Quote, Opening <br />F-1 Change Order No. <br />0 Ease/Encroach. <br />F1 Other: <br />■Contract <br />❑Resolution <br />F] Bid Award <br />■Quote Award <br />C/O & PCA No. 2 Final <br />F-1 Traffic Control: <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />MBEANBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />ME=$ <br />FWAX 111% we <br />n Req, to Advertise E] Title Sheet <br />The Robert Henry Corporation (Division A & Alternate Al) <br />El Yes E No If Yes, Approved by. Purchasing <br />❑ MBE [:1 WBE <br />[TN_ oE:1 Yes Name of Company <br />Newman Center Site Development <br />117-06OR <br />REDA TIF <br />429-1050-460-42.02 (Division A & Alternate Al) <br />Proiect Closeout <br />[:] Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non-Discrim !nation . Non -Debarment, E-Verifv. Iran. etc. <br />Amount of M Increase $3,275.25 <br />Decrease $ <br />Previous Amount $ 336,554.32 <br />Current Percent of Change: 0.97% <br />New Amount $ 339,829.57 <br />Total Percent of Change: -8.46% <br />Dispersal After Approval <br />Copy Original <br />F-1 F1 <br />1:1 1:1 <br />El 1:1 <br />