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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date November 5, 2018 Department Public Works <br />Name Becca Plantz <br />Division/Bureau Engineering <br />............ .............. _._.---- ..�........�._���..� <br />BPW Date November 11, 2018� Phone Extension 5998 <br />�om�.✓wnv�rv�s�..�...raw',mw.w�uz^�u^r�rw✓��u�sa�uew±.yaw-n�aorr✓rsww�orvu�w,luuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuwrtwwrvurnww,wrrw�rw�Frw,uw.w.....!rs�a..::.....,,,� ..... ...,.r�awmaa�mraaa�aa�r,�a�adu�erairimrinrtmmm^ow�wAmmvwwvvvvvmmvwvmwwwvvvwwwuuNuuvmiwwumanuwv,�wwn� <br />� .m A .....� ..... <br />..............__..........m ........ .m.......,.,.,�..,�.µ..... ............�_........... <br />Required Prior to Submittal to Board <br />Legal Z <br />Attorney Name: Clara McDaniels <br />Controller E <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 R <br />m ..... _ _ <br />Check the rpri t Item Tpafor All Submissions <br />Agreement Amendment <br />El Contract El Proposal ❑ Addendum <br />Z Professional Services <br />n Resolution <br />n Bid Opening <br />El Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />Ej Quote Opening <br />EJ Quote Award <br />0 Change Order No. <br />C/O & PCA No. ❑ PCA <br />E] Ease/Encroach. <br />Traffic Control: <br />n Other: <br />Required Information <br />Company or Vendor Name <br />"roype ProuP <br />... ........ <br />El Yes ❑ No -El If Yes, Approved by <br />New Vendor <br />Purchasing.W _�............. .......... W....................................�.�.�.�.................�. <br />MBEANBE Contractor <br />Fj MBE WBE <br />MBE/WBE Contractor Requested <br />..... . mm . y ,,.,.,..ee...... <br />_ � No � Yes Name of Com�a�n? <br />Name <br />ProjectCentury <br />Exterior Landscape <br />Centu Center Exte ............................... <br />Project Number <br />118 101 <br />Funding Source <br />............. . <br />Hotel Motel <br />Account No. <br />7304.42010.000.0099 <br />Amount <br />$14,700 <br />Terms of Contract <br />.. Not to �......._��--- ----- m.. . . �,n. �m� ..... ... ,......w-..w. <br />Exceed <br />Purpose/Description <br />To update the exterior landscape at Century Center on the West <br />d South side of the buildingT � . ..� �_—.. <br />Required Contractors Certification Forms Attached <br />' hed (Non <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />�...� Required For Change Orders n .. � . <br />Amount of F-1 Increase <br />$ _____ <br />F] Decrease <br />$ <br />Previous Amount $ <br />Current Percent of Change: <br />New Amount $ <br />Total Percent of Changer <br />% <br />_.-..---- ............�..Di <br />p�r�alAfterApproval <br />Copy Original..........��......�� <br />..... ....._ _._..__...-r� <br />® ❑ Becca Plantz <br />