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BOARD OF PUBLIC WORKS <br />AGENDA ITEM RE VIEW REQUEST FORM <br />Date 06/07/2018 <br />Name Patrick Sherman Department -Venues Parks & Arts <br />BPW Date 06/12/20 18 <br />Phone Extension 5601 <br />Required Prior to Submittal to Board, <br />Legal <br />Attorney Name Clara IMcDaniels <br />Controller ❑ <br />Controller review is required for all Contracts $5,000.001 or more and <br />'greater than one year in length per the City Purchasing Policy <br />Purchasing <br />Michael Schmidt <br />Check the, Appro <br />riate Item Type — 1?e uired for All Submissions <br />F-1 Agreement <br />F] Contract 0 Proposal El Addendum <br />R Professional Services <br />R Resolution <br />F-1 Bid Opening <br />F] Bid Award F1 Req. to Advertise El Title Sheet <br />F-1 Quote Opening <br />0 Quote Award <br />El Change Order No. <br />F] C/O & PCA No. F-1 PCA <br />F-1 Ease/Encroach. <br />El Traffic Control <br />El Other: <br />F <br />Reggired Information <br />Company or Vendor Name <br />R. Yoder Construction <br />New Vendor <br />R Yes E No E] If Yes, Approved by Purchasing <br />MBENVBE Contractor <br />❑ MBE F WBE <br />MBEANBE Contractor Requested [:] No R Yes Name of Company <br />Project Name <br />Rum Village Dog Park Construction <br />Project Number <br />1060-2018 <br />Funding Source <br />2015 Park Bond <br />Account No, <br />751-1101-452-39,89 <br />Amount <br />$ 120,405.00 <br />Terms of Contract <br />60 Days <br />Purpose/Description <br />Construction of Rum Village Dog Park <br />M Required Contractor's Certification Form Attached (Noin- <br />Collusion. Non -Discrimination. Non -Debarment. E-Verifv. [ran. etc.) <br />Amount of [I increase <br />F-1 Decrease <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Dispersal After Approval <br />Copy <br />Original <br />1:1 <br />F-1 <br />F-1 <br />F-1 <br />El <br />El <br />