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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 06 /06/2019 <br />Department VPA: Facilities & <br />Name Patrick Sherman Grounds <br />BPW Date 06/11/2019 Phone Extension 5601 <br />�a� m mmwmmwwnoi�omomo�mo�mmmm�omm�o�mm�oimmnemurt�rcnw�nrtmnMa�mumu �uemawewaen! rev r� u�m unr�rrrexurermr m09 <br />Re uired 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 A <br />j Agreement <br />❑ Professional Services <br />El Bid Opening <br />Quote Opening <br />El Change Order No. <br />El Ease/Encroach. <br />IF Other: <br />,roriate Item Type — <br />El Contract <br />Resolution <br />d for All Submissions <br />Proposal <br />❑ Bid Award ❑ Req. to Advertise <br />Quote Award <br />( C/O & PCA No. ❑ PCA <br />Traffic Control <br />Rdouired Information <br />Company or Vendor Name Acorn Landscaping LLC <br />Addendum <br />❑ Title Sheet <br />New Vendor F] Yes Z No El If Yes, Approved by Purchasing <br />MBE/WBE Contractor ❑ MBE E WBE <br />MBE/WBE Contractor Requested ® No ❑ Yes Name of Company <br />Project Name 2019 City Cemetery Paths <br />Project Number 108� <br />j 4-2019 <br />Funding Source COIT <br />Account No, 408-1001-460.42-01 <br />Amount $ 46,830.00 _ <br />Terms of Contract 45 Days; 3500 lin/ft <br />Purpose/Description Phase 2: Resurfacin <br />N Required Contractor's Certification Form Attached (Non - <br />Collusion, Non Discrimination Non Debarment, E-Veri ,, Irarl, etc. <br />Required For Change Orders Onl <br />Amount of ❑ Increase $ <br />❑ Decrease <br />Previous Amount $ <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: - <br />Dispersal After Approval <br />Copy <br />Original <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />