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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />1/15/19 <br />Silveus <br />Department Enaineeri <br />BPW Date 1/22/2018 Phone Extension 9083 <br />Required Prior to Submittal to Board .._._ ...._._._. <br />Legal Attorney Name Clara McDaniels <br />Controller El Controller review is required for all Contracts $5,000.00 or more anc <br />greater than one year in length per the City Purchasing Policy <br />Purchasing F-1 Michael Schmidt <br />Check the Appropriate Item Type — <br />LJ Agreement <br />EProfessional Services <br />n Bid Opening <br />El Quote Opening <br />® Change Order No. 6 <br />❑ Ease/Encroach. <br />Other: <br />Contract <br />Resolution <br />[l Bid Award <br />n Quote Award <br />❑ C/O & PCA No, <br />❑ Traffic Control <br />for All Proposal <br />.._................._..........�............__. <br />osal Addendum <br />❑ Req. to Advertise ❑ Title Sheet <br />uired Information <br />❑ PCA <br />Company or Vendor Name Ziolkowski Construction Inc <br />New Vendor Ej Yes El No ❑ If Yes, Approved by Purchasing <br />MBE/WBE Contractor [: MBE ❑ WBE <br />MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company <br />Project Name Erskine Clubhouse Renovation <br />Project Number 116-108 <br />Funding Source <br />Account No. <br />Amount <br />$62,958.00 <br />Terms of Contract <br />Purpose/Description <br />_ <br />Misc. Items due to unforeseen conditions including _ ............... <br />conditions lead and <br />asbestos abatement tuck Pointina, additional duct work lumbin <br />snack bar roof and walls cleanout relocation block work and stair <br />repairs, <br />❑ Required Contractor's Certification Form Attached (Non- <br />�_..W__ <br />Non Debarment E 1 , <br />_..l ,�_- iminat _.._.... " er�fy, ran etc. <br />......_. __.�_��_.__..._. <br />hcriminatior�, <br />Ieuurd For Csart a Orders QI.... <br />Amount of � <br />_... <br />Increase $ 62,958.00 <br />Decrease $ <br />Previous Amount <br />. $.... _,.� .........r �.....���__..�.__ ...� <br />924,184.00 <br />w <br />Current Percent of Change: 6.m� m, __.....................................��. �� <br />g 81% <br />New Amount <br />$ 987,142.00 <br />................................ <br />TotalPercent of Change: 8.84%��m_�.......................m...�...e�. .....................�...�.�.......................�..�.�...—_.�� <br />Dis ersal After Approval <br />Copy Original' <br />® ❑ <br />Kyle Silveus <br />❑ <br />Patrick ShermanEl <br />_.. �..............rw.......................................�.�.......... �� �............... m, ..�,,,..�m...._........� <br />