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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 11/19/18 <br />Name Sue Ellen Doudrick <br />Department Public Works <br />Division/Bureau Engineering <br />BPW Date 11/27/18 Phone Extension 5992 <br />. ............... <br />to Board <br />_Bequired Prior to Submittal to Board <br />Legal ❑ 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 />Check the <br />El Agreement Amendment <br />7 Professional Services <br />E] Bid Opening <br />El Quote Opening <br />F-1 Change Order No. <br />F-1 Ease/Encroach. <br />71 Other: <br />Company or Vendor Name <br />pro p�ri.ate...Item .lype - <br />Contract <br />Resolution <br />Bid Award <br />Quote Award <br />C/O & PCA No. <br />El Traffic Control: <br />New Vendor <br />MBE/WBE Contractor <br />MBE/WBE Contractor Requested <br />,d for All Submissions <br />LProposal <br />................ ­­ <br />E:1 Req. to Advertise <br />[:1 PCA <br />Reauired Information <br />Precision Wall <br />Yes E No <br />Purcha S1 in <br />9L <br />ms <br />Addendum <br />El Title Sheet <br />If Yes, Approved by <br />L_J MBE 0 WBE <br />... M ......... No E] Yes Name of C qMpany <br />Project Name <br />"Three Twenty Cascades"- Glazed Assemblies . . ........ . . <br />Project Number <br />11 8-074A <br />Funding Source <br />River East TIF <br />Account No. <br />429 <br />Amount <br />1 44 8,000 <br />Terms of Contract <br />— — ­­- <br />Unit Prices - - ­­- <br />Purpose/Description <br />.................. <br />Installation of the glazed assemblies of the building being <br />constructed at 320 Colfax Avenue. <br />F-1 Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />r Cha Orders <br />Fo._- — — - ... . . ....... <br />Amount of E <br />increase $ . .............. . . . . . . . . ...... <br />0 <br />Decrease $ <br />Previous Amount <br />$ <br />........... Current Percent of Changer % <br />New Amount <br />Total Percent of Chance: % <br />I After Armroval <br />Copy <br />Original <br />F-1 <br />F-1 <br />F-1 <br />F] <br />El <br />El <br />