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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 11/4/2019 <br />Name Kyle Silveus <br />Department Engineering <br />BPW Date 11/12/2019 Phone Extension 9083 <br />Rogl6ired Prior to Submiftal,to, Board <br />Legal El Attorney Name Clara McDaniels <br />Controller El Controller review is required for all Contracts $5,000.00 or more anc <br />greater than one year in length per the City Purchasing Policy <br />Purchasing <br />"Agreement <br />F-1 Professional Services <br />0 Bid Opening <br />F-1 Quote Opening <br />M Change Order No. 2 <br />El Ease/Encroach. <br />F-1 Other: <br />F-1 Michael Schmidt <br />LJ Contract <br />E] Resolution <br />0 Bid Award <br />F-1 Quote Award <br />F-1 C/O & PCA No. <br />F-1 Traffic Control <br />Proposal <br />0 Req. to Advertise <br />[I PCA <br />Company or Vendor Name Larson Danielson Construction Co, Inc. <br />New Vendor E] Yes 0 No [] If Yes, Approved by Purchasing <br />MBE/WBE Contractor F-1 MBE F-1 WBE <br />MBE/WBE Contractor Requested 0 No F-1 Yes Name of Company <br />Project Name Pulaski Park Improvements <br />Project Number 118-056 <br />Addendum <br />E] Title Sheet <br />Funding Source RW TIF Bond <br />........... .................. ---- ............. <br />Account No. 452-1101-452.31-06 <br />-'2,284.00""-"" — <br />Amount <br />............. <br />Terms of Contract <br />. ........ ........ - . .............. ....... . . ........ <br />Purpose/Description Miscellaneous credits and char es due to unforeseen conditions <br />and scope changes. <br />n Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Amount of increase $$2,284.00 <br />Decrease <br />Previous Amount 1878,686.25— <br />Current Percent of Change: 0.26% <br />New Amount <br />Total Percent of Change <br />Copy <br />Original <br />F-1 <br />F-1 <br />F-1 <br />El <br />, . 1 0 1 <br />4141, . <br />Dispersal After Approval <br />