Change Order No 4 - VPA Maintenance Storage Building Project No 118-046R - The Robert Henry Corporation

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 1 /15/19 Name Alicia Czarnecki/Toy Villa Department Engineering BPW Date 1/22/19 Phone Extension 5903 WWWWWW Required Prior to Submittal to Board �..._ �....... _ ....... .......M Legal ❑ Attorney Name Controller Controller review is required for all Contracts $5,000.00 or more and greater than one year in length per the City Purchasing Policy Purchasing El Check the II Agreement F] Professional Services Bid Opening ❑ Quote Opening ® Change Order No. 4 Ease/Encroach, El Other: F nate Item Type - Contract F1 Resolution ❑ Bid Award Quote Award ❑ C/O & PCA No. _ ❑ Traffic Control for All Submissions Proposal 0 Addendum ❑ Req. to Advertise ❑ Title Sheet Required Information Company or Vendor Name The Robert Henry Corporation ❑ PCA New Vendor ❑ Yes ❑ No ❑ If Yes, Approved by Purchasing MBE/WBE Contractor ❑ MBE [:] WBE MBE/WBE Contractor Requested ❑ No [:] Yes Name of Company Project Name VPA Maintenance Storage Building Project Number 118-046R Funding Source Park Bond Series Account No. .............................. 471-1138-452.42-01 Amount $ Terms of Contract . Purpose/Description A �...............0 Approval of C.O. #4 ❑ Required Contractor's Certification Form Attached (Non - Collusion„ Non -Discrimination, Non -Debarment. E-Veri'ty. Iran. etc. Required For Chancie Orders Onl Amount of Z Increase $ 1,490 00 Decrease $ Previous Amount $ 387,890.00 _.................................. Current Percent of Change: 0.384% _ ...... New Amount $ 389,380.00 ............... ._................ . ........... Total Percent of Change: 17.864% ............... Dispersal After Approval Copy Original ® ❑ Toy Villa ❑ ❑