Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />O�7/02/2018 <br />Department <br />Public Works <br />Name <br />Toy Villa -­Q <br />Division/Bureau <br />Engineering <br />BPW Date <br />07/10/2018 <br />. . .. . . ........ Phone Extension <br />5920 <br />Legal [J Attorney Name: <br />Controller D 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 />H <br />Agreement <br />H Contract LJ Proposal LJ Addendum <br />El <br />Professional Services <br />El <br />Resolution <br />E] <br />Bid Opening <br />El <br />Bid Award El Req. to Advertise El Title Sheet <br />F-1 Quote Opening <br />n Quote Award <br />Change Order N'o. 2, <br />n C/O & PCA No. ❑ PCA <br />Ease/Encroach. <br />F] Traffic Control: <br />Other: <br />Company or Vendor Name <br />New Vendor <br />MBEIWBE Contractor <br />MBEMBE 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 />F] <br />B.C. Mechanical, Inc. <br />F]- Yes M No 0 If Yes, Approved by Purchasing <br />MBE F-1 WBE <br />No F1 Yes Name of Company <br />Studebaker Museum Rooftop Unit Replacements <br />117-081 <br />Liability Insurance <br />226.04117.672.39.01 <br />R <br />Chancte Breakers <br />F-1 Required Contractor's Certification Forms Attached {Non.. <br />Collusion, Non -Discrimination, Non -Debarment, E-Verifv, Iran, etc. <br />Increase $4,725-00 <br />Decrease $ <br />Previous Amount $ 157,573.00 <br />Current Percent of Change: 3.00% <br />New Amount $ 162,298.00 <br />Total Percent of Change: 137% <br />Copy <br />Original <br />❑ <br />❑ <br />