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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 3/29/19 Department Public Works <br />..... . ...... .... <br />Name Kyle Silveus Division/Bureau Engineering <br />Purchasing ❑ <br />Check the <br />H Agreement <br />El Professional Services <br />❑ Bid Opening <br />❑ Quote Opening <br />❑ Change Order No. <br />Q Ease/Encroach. <br />Other: <br />Michael Schmidt <br />iropriate Item T ripe— <br />❑ Contract <br />❑ Resolution <br />® Bid Award <br />Quote Award <br />El C/O & PCA No. <br />R Traffic Control: <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />MBE/WBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />uired Info <br />ed for All Submissions <br />Proposal <br />❑ Req. to Advertise <br />❑ PCA <br />n <br />Hardman Construction, Inc. <br />Main and Jefferson Earthwork <br />119-022 <br />RWDA TIF <br />324-1050-460.42-01 <br />$265,000 <br />Addendum <br />❑ Title Sheet <br />Terms of Contract Base Bid <br />Purpose/Description Earthwork Retention System for Main St./Jefferson St. <br />Development <br />❑ Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />!red For Chaps Ordersr� <br />Amount of ❑ Increase $ ITITITITIT_mITITITITmmmmm <br />........................... <br />Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Chanoe:-ITITITITITmmmmmmmmmmm% <br />Disoersal After <br />Copy <br />Original) <br />® <br />❑ Kyle Silveus <br />❑ <br />