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Project Completion Affidavit - Gemini at Washington-Colfax Apts Masonry & Stair Repair Project No 118-080B - Pauls Welding
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Project Completion Affidavit - Gemini at Washington-Colfax Apts Masonry & Stair Repair Project No 118-080B - Pauls Welding
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4/8/2025 2:35:56 PM
Creation date
8/28/2019 10:56:40 AM
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Board of Public Works
Document Type
Projects
Document Date
8/27/2019
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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 8/08/20 9 <br />7 <br />Name "I'o Villa <br />Department„ Engineering <br />._..._....._...._ w w w... _ — .......... <br />BPW Date 8/27/2019 Phone Extension 5920 <br />flu�ummmmommmmmmmon'Mo owmmmmmwnmmnMrnmmr;m wmmmmmuammmmmwwmmmwwwmmw ,.... im��im vv <br />' to Submittal to <br />..._......._w_ R utr Pnor .......� Board ....... ._.......... <br />BPW Attorney Attorney Name <br />Dept. Attorney Attorney Name <br />Purchasing ❑I <br />............ .... C. <br />Check the ,ADDronriat - Item Tvne ..- <br />LJ Professional Services Agreement ❑ Contract <br />Open Market Contract El Amendment/Addendum <br />[� Bid Opening <br />E] Bid Award <br />❑ Quote Opening <br />❑ Quote Award <br />EJ Proposal Opening <br />❑ C/O & PCA No. <br />E] Chg. Order, No. <br />❑ Traffic Control <br />Other: <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Paul's Wel <br />❑] Yes❑ <br />15-1,1 No <br />Information <br />Inc. <br />lbr All Submissions <br />El Proposal <br />Fj Special Purchase, QPA <br />❑ Req. to Advertise ❑ Title Sheet <br />❑ Reject Bids/Quotes <br />PCA <br />Resolution <br />Ease./Encroach <br />If Yes, Approved by Purchasing <br />MBE Completed E-Verify Form Attached Nos <br />WBE <br />Gemini at Washington -Colfax Apartments Masonry and Stair Repair <br />118-080B <br />West Washington TIF <br />�..._ ............. -------- .. _ ............_.w._ ............... <br />422.1050.460.42.02 <br />....... ..._._ .. ... _— <br />Project_ Closeout <br />For ClInp Orders Onlyy ,w m.... .._ ___...... <br />Amount of Increase $ <br />Decrease ($ ) <br />Previous Amount $ <br />Increase �.�.�.�.�.�.�.�.�.�.............................. ��-.............._..�.�_..... �-_.�_��m.�....._................... <br />0 <br />Current Percent of Change: Decrease ( /o <br />New Amount <br />Increase % <br />Total Percent of Change: Decrease <br />Time Extension Amount: <br />New Completion Date: <br />
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