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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 2/4/19 <br />Name Tour Villa/Alicia Czarnecki Department Engineering <br />...... . ............. <br />BPW Date 2/12/2018 Phone Extension 9083 <br />.................. <br />... . . . . ................. . . ................ . R uir�ed 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 />"Agreement <br />El Professional Services <br />Bid Opening <br />Quote Opening <br />Change Order No. 8 <br />Ease/Encroach. <br />Other: <br />FroItemTy <br />rate Ite- <br />_ <br />Cp <br />0 <br />ontract <br />R Resolution <br />El Bid Award <br />El Quote Award <br />F-1 C/O & PCA No. <br />R Traffic Control <br />for All Submissions <br />FProposal 0 Addendum . <br />F] Req. to Advertise [] Title Sheet <br />ired Information <br />0 PCA <br />Company or Vendor Name Ziolkowski Construction, Inc. <br />New Vendor Ej Yes E No F] If Yes, Approved by Purchasing <br />MBEIWBE Contractor Fj MBE [:] WBE <br />MBENVBE Contractor Requested [:] No F-1 Yes Name of Company <br />Project Name Erskine Clubhouse Renovation <br />. .. . ............ .......... <br />Project Number 116-108 <br />Funding Source V FA AAC"'(A <br />Account No. 201. it - I. if <br />. .................. ..................... .... . .............. <br />Amount $23,864.00 <br />Terms of Contract <br />Purpose/Description Porch Repairs due to unforeseen conditions, <br />0 Required Contractor's Certification Form Attached (Non- <br />.......... Collusion, Non -Discrimination, Non -Debarment, E-Ved!y1ran, etc. <br />Required For Change Orders Only <br />........... ......... <br />Amount of increase " $23,864.00 . .......... ... ­­ ............................. . ................... <br />F-1 Decrease <br />Previous Amount $ 990,126.00 <br />Current Percent of Change* 2.41% <br />New Amount <br />1,013,990.00 <br />Total Percent of Change: 11.57% <br />. ... . . .................... <br />Dispersal After Approval <br />Copy Original <br />z F-1 Kyle Silveus <br />z F-1 Patrick Sherman <br />R El <br />