Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 11/05/2018 Department Public Works <br />Name To Villa Division/Bureau Engineering <br />. . . ............. <br />BPW Date 11/13/2018 Phone Extension 5920 <br />MqumiredITmPrior to Submittal to Board <br />. ITIT ........ ... . . ..... ... . ................ <br />Legal 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 <br />Check the, <br />❑ . . . ....... --- . ...... -- <br />Agreement Amendment <br />Professional Services <br />F-1 Bid Opening <br />F-1 Quote Opening <br />Z Change Order No. 3 <br />F-1 Ease/Encroach. <br />F Other: General Release <br />Company or Vendor Name <br />iro riate Item Type <br />F1 Contract <br />El Resolution <br />El Bid Award <br />Quote Award <br />❑ C/O & PCA No, <br />Traffic Control: <br />New Vendor <br />MBEANBE Contractor <br />MBE/WBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />ired Information <br />Walsh & Kelly, Ing. <br />roval of C.O. #3 <br />for All Submissions <br />I Proposal <br />Req. to Advertise <br />Addendum <br />El Title Sheet <br />F-1 Required Contractor's Certification Forms Attached (Non - <br />Collusion, N on-Discri m i nation, Non -Debarment, E-Verif , <br />.... . ............. ............. .. . . ---- - - �ilra�netc,�.. <br />Required For Change Orders Only <br />[Z Increase $786-00 <br />Amount of Decrease <br />. . ...... .. <br />Previous Amount 1 6 7 1 1 52 .60 <br />Current Percent of Change, 0.05% <br />New Amount -�-l","671',968'.'60 <br />........... <br />Total Percent of Change 0.78% <br />. . ........ <br />Disversal After Awroval <br />Copy <br />Original <br />1:1 <br />El <br />n <br />El <br />1:1 <br />n <br />