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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />11/08/2018 <br />Patrick Sherman <br />Department Venues Parks & Arts <br />BPW Date 11/13/2018 Phone Extension 5601 <br />HUME <br />. ........... <br />Required Prior to Submittal to Board <br />- - - - ------ <br />Legal Z Attorney Name Clara McDaniels <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 Michael Schmidt <br />— — ------ -------- . ............. . ....... .... <br />LJ Agreement <br />El Professional Services <br />[:1 Bid Opening <br />F-1 Quote Opening <br />Z Change Order No. 02 <br />El Ease/Encroach, <br />F Other: <br />Contract <br />Resolution <br />El Bid Award <br />R Quote Award <br />El C/O & PCA No. <br />0 Traffic Control <br />Company or Vendor Name R. Yoder Construction <br />Proposal <br />n Req. to Advertise <br />[:1 PCA <br />Addendum <br />0 Title Sheet <br />New Vendor <br />E] <br />Yes E No [:] If Yes, Approved by Purchasing <br />MBENVBE Contractor <br />[—] <br />MBE R WBE <br />MBEANBE Contractor Requested E] No F-1 Yes Name of Company <br />Project Name <br />Rum Village Dog Park Construction . . .............. <br />Project Number <br />1060-2018 <br />Funding Source <br />mw <br />2015 Park Bond <br />Account No. <br />....... . . ... <br />751-1101-452-39.89 <br />Amount <br />- ... ..... ... .. ................................................ <br />1 43 25 .31 <br />Terms of Contract <br />. .. ........ <br />60 DaYA,-- . . . . ........ — -- — ------ <br />Purpose/Description <br />Addressing issues in making path ADA compliant Plus manhole <br />covers <br />Z Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-yffi Iran etc.) <br />Required For Chanq,,e Orders Only <br />Amount of N Increase $13,077.31 <br />R Decrease $ <br />Previous Amount <br />Current Percent of Changer <br />New Amount <br />Total Percent of Change: <br />Copy <br />Original <br />F-1 <br />F-1 <br />n <br />El <br />n <br />El <br />