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Project Completion Affidavit - 2017 Brick Column Repairs Proj No 117-126 - C&S Masonry Restoration
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Project Completion Affidavit - 2017 Brick Column Repairs Proj No 117-126 - C&S Masonry Restoration
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Last modified
4/4/2025 10:15:24 AM
Creation date
8/15/2018 11:14:20 AM
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Board of Public Works
Document Type
Projects
Document Date
8/14/2018
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11 <br />BOARD OF PUB1,IC WORKS <br />AGENDA ITEM REVIEW INQUEST <br />07/24/2018 <br />Tow Villa <br />Department Enaineerin <br />BPW Date — 08/14/2018_._.__.__._ ", 1 Phone Extension 5920 ------ <br />Legal F-1 Attorney Name <br />Controller ❑ <br />Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing El <br />Check the Appropriate Item Type — Re,quired for All Submissions <br />El Agreement El Contract E] Proposal F-1 Addendum <br />F-1 Professional Services El Resolution <br />F-1 Bid Opening E] Bid Award E] Req. to Advertise F-1 Title Sheet <br />F-1 Quote Opening E] Quote Award - Possible <br />F-1 Change Order No. F] C/O & PCA No. PCA <br />0 Ease/Encroach. F] Traffic Control <br />F-1 Other: <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />MBE/WBE Contractor <br />Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />C & S Masonry Restoration, LLC <br />EJ Yes 0 No E] If Yes, Approveg_ <br />Z MBE 2 WBE <br />El No El Yes Name of Company <br />2017 Brick Column Repairs <br />117-126 <br />EDIT <br />408.1001.460.39.64 <br />$ 11,493.00 <br />Project Closeout <br />F-1 Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc. <br />Amount of El increase <br />[:] Decrease <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />Copy <br />Original <br />F-1 <br />El <br />11 <br />1-1 <br />El <br />El <br />
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