Change Order No 6 - Fire Station No 9 Project No 116-012 - Ziolkowski Construction Inc

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 07/22/2019 Name Toy Villa/Alicia Czarnecki Department Division/Bureau Public Works Engineering BPW Date 08/13/2019 Phone Extension 5920 iu i� ^-^�.... �-� �^+�r �u�ure�wear�,wraarm�waus uuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuumm�w!�www��wwwiwu�u��rvrt?�m�mirrmuuu;�rearrr¢ws� Required Prior to Submittal to Board _.... ........ ..... ........... ....... Controller ❑ Controller review is required for all Contracts $5,000.00 or more and greater than one year in length per the City Purchasing Policy Purchasing El Check the Agreement Amendment Professional Services Bid Opening ❑ Quote Opening ® Change Order No. 6 Ease/Encroach. Other: Company or Vendor Name Tgpriate Item Tie — Contract Resolution j Bid Award F Quote Award ❑ C/O &PCANo. _ ❑ Traffic Control: New Vendor MBE/WBE Contractor MBE/WBE Contractor Requested Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description for All Submissions G Proposal ❑ Req. to Advertise ired Information ❑ PCA Ziolkowski Construction, Inc. Approval ofyC.O. #6 Addendum ❑ Title Sheet ❑ Required Contractor's Certification Forms Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-_Iran, etc. Required For Change Orders OnI_....___.......__ _.._ _.......... � Amount of 7.�. �.....�� Decrease e $ Increase 3,153.50 Previous Amount $ 3,644,549.00 Current Percent of Change: 1.02% ........ ..__�w�w�w ........................w�_... ...,,,,,,........._......... ..,........... .................. ................................................._ New Amount $ 3,681,702.50 Total Percent of Chang 0.80% D.i persal After Approval ...... ..mw_. Copy Original ® ❑ Steve Cox Todd Skwarcan ❑ ❑ �........ �........m..... ....................._� ........_ ...