Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 0,8/0612018 <br />Name Toy Villa Department Engineering <br />-BPW Date 0811412018 Phone Extension 5920 <br />F Required Prior to Submittal to Board <br />Legal [J Attorney Name <br />Controller ❑ Controller review is required for all Contracts $5,000.00, or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing El <br />F-1 Agreement LJ Contract LJ Proposal ❑ Addendum <br />F Professional Services R Resolution <br />F-1 Bid Opening E] Bid Award E] Req. to Advertise El Title Sheet <br />[] Quote Opening El Quote Award <br />Z Change Order No. 3 ❑ C/O & PCA No. F] PCA <br />F-1 Ease/Encroach. ❑ Traffic Control <br />F-1 Other: <br />Company or Vendor Name Gibson -Lewis, LL <br />New Vendor <br />Yes Z No F1 If Yes, Approved by Purchasing <br />MBEANBE Contractor <br />❑ MBE [:] WBE <br />MBEANBE Contractor Requested <br />E] No [:] Yes Name of Company <br />Project Name <br />- Charles Black Center Renovation <br />Project Number <br />-.116-073 <br />Funding Source <br />Park Bond - <br />Account No. <br />Park Bond: 751 A 101.452.39,89 <br />Amount <br />$ <br />Terms of Contract <br />Purpose/Description <br />Addition of Misc. Items and including deducts,_ Please see attached. <br />F-1 Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Required For Charge Orders n.n.. .... <br />Amount of ❑ Increase $ 35,391 .00 <br />El Decrease $ <br />Previous Amount <br />$ 3,886,246.00 <br />Current Percent of Change: <br />0.91% <br />New Amount <br />$ 3,921,637,00 <br />Total Percent of Change: <br />3.31% <br />Dispersal After Approval <br />Copy Original <br />n 1:1 <br />-- <br />Eli 1-1 <br />El <br />