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Project Completion Affidavit - Code Enforcement Office Improvements - Brown & Brown General Contractors
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Project Completion Affidavit - Code Enforcement Office Improvements - Brown & Brown General Contractors
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4/8/2025 2:32:06 PM
Creation date
7/24/2019 1:58:50 PM
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Board of Public Works
Document Type
Projects
Document Date
7/23/2019
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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />BPW Date <br />July 1,12019 <br />Adam Parsons.,,,.,.,.m....��.. �...���������.......................�....._... Central Services <br />Jt1 <br />2019 <br />Phone Extension 9302 <br />r to Submitta.. ....... �.. . <br />�.mmmm 1 to Board 1,��c��rcd Prior ....... _........ <br />BPW Attorney X Attorney Name Clara McDaniels <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ❑ <br />Check the Appropriate Item °hype -- <br />❑ Professional Services Agreement Contract <br />❑ Open Market Contract ❑ Amendment/Addendum <br />F] Bid Opening ❑ Bid Award <br />Quote Opening ❑ Quote Award <br />EJ Proposal Opening [ C/O & PCA No. <br />Chg. Order, No. F] Traffic Control <br />Other: <br />ared Jbr All Submissions <br />Required Information <br />L-1 Proposal <br />El Special Purchase, QPA <br />�] Req. to Advertise <br />❑ Reject Bids/Quotes <br />® PCA <br />Resolution <br />E] Ease./Encroach <br />.....___. <br />❑ Title Sheet <br />Company or Vendor Name <br />Brown and Brown General Contractors„ Inc. <br />.........�__........__...�_ � �,, .......... ��. <br />Yes If Yes, Approved by Purchasing <br />New Vendor <br />®No <br />❑❑ �❑ <br />MBE/WBE Contractor <br />WBE Completed E-Verify Form Attached <br />Nos <br />Project Name <br />Code Enforcement Office Improvements.__ <br />Project Number <br />.............................. <br />Funding Source <br />Code Enforcement <br />Account No. <br />_._..._........................w..�.�.__................�....�..___.�����...�. <br />9-89 <br />Amount$8,894......._�_��........ <br />_600-1201._.41......�_ <br />..-............................w _ � .-.............. �_ � ...� _._.................._. <br />Terms of Contract <br />......_... __................... _ ... _......�. w ... .... ................... <br />Lump Sum <br />Purpose/Description <br />........ .... ........ ... ..... _... -"��_.,���..._���....._���....... .-------------- _..........----- ........ <br />Project Closeout <br />_.. — <br />� � <br />__ .._._w ..... .... _. <br />��.m.....�.,,.... For Clia ge Orders + r l <br />Amount of � <br />Increase $ ..... ..........�. m,��_.........�.. <br />..__..�.. a,.���... <br />[� <br />Decrease �$ ) <br />Previous Amount <br />..��_............�����.....m............���_.__...�m�.�..._.._..........._.._� <br />Increase.........._................._...�___�..�.�.............�....... �-.�..�.�.�.�.............................................................. �..�_....................._. <br />Current Percent of Change: <br />Decrease /°) <br />New Amount <br />$ <br />Increase %.._�....... �. _....,,,._ �.a�._......�......�.��.m..�_�. <br />Total Percent of Change: <br />Decrease ..............................o _m ... �._ <br />%) <br />Time Extension Amount: <br />New Completion Date: <br />
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