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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date December 17, 2018 <br />Name Scott Kreeger <br />Department Public Works <br />Division/Bureau Engineering <br />BPW Date December 20, 2018 Phone Extension 9245 <br />uuwmlwm�m mmm mmmamammumm�mmm�mwwu re <br />..._..... Required Prior to Submittal to Board _ I <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 <br />Check the <br />LJ Agreement Amendment <br />n Professional Services <br />El Bid Opening <br />❑ Quote Opening <br />El Change Order No. <br />Ease/Encroach. <br />Other: <br />Michael Schmidt <br />iriate Item Type — <br />I I Contract <br />[:] Resolution <br />uired for All Submissions <br />Proposal <br />El Bid Award ❑ Req. to Advertise <br />® Quote Award <br />❑ C/O & PCA No. PCA <br />❑ Traffic Control: <br />Required Information <br />Company or Vendor Name _Facelift P ainting & Powerwashing mm _._.IT ... _ <br />New Vendor Yes _ No Z If Yes, Approved by Purchasin <br />MBE/WBE Contractor MBE WBEmmITITmmmmmmmm <br />_.................................... <br />MBE/WBE Contractor Requested [A No E] Yes Name of Company <br />Addendum <br />❑ Title Sheet <br />Project Name Colfax Water Works BuildingmmRepainting <br />Project Number 118-055 <br />Funding Source . Building Repairww& MaintenanceITITITITmmmmmmmm ............... <br />Account No. 620-0640-657.36-01 <br />Amount $19,153.85 <br />Terms of Contract Base Bid + Alt 1 <br />............. ........ ....._ ............... <br />Purpose/Description Repair and repaint the exterior of the Water Works utility building <br />on ............... <br />Colfax Avenue <br />Required Contractor's Certificatio ❑ q n Forms Attached (Non- <br />_. <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />q rdey�� <br />. _._ .... Re uired For Chan e rs Onl O er..�.. <br />Amount of Increase $ <br />Decrease $ <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Chanae: <br />Dispersal After A <br />Copy <br />Original <br />® <br />❑ <br />® <br />❑ <br />0 <br />❑ <br />