Spreadsheet: 8bbcb4d1-6e7c-4412-86e2-cd1aa1b5460d
Sheet: Contract Amendment

CONTRACT
Ordinance  Fact Sheet |  |  |  |  | Amendment Form
Brief Title |  |  |  | Approval Deadline |  |  | Reason
 |  |  |  |  |  |  | To authorize execution of                         agreement.
Details |  |  |  |  |  |  | Roles and Responsibilities
Reason for Contract |  |  |  |  |  |  | Sponsor
 |  |  |  |  |  |  |  | Department
 |  |  |  |  |  |  | Department
 |  |  |  |  |  |  | or Programs
 |  |  |  |  |  |  | Affected | Department
 |  |  |  |  |  |  | Recommended
 |  |  |  |  |  |  | Awardee | Company
 |  |  |  |  |  |  | Contract
 |  |  |  |  |  |  | Compliance
 |  |  |  |  |  |  | Certification |  |  | No | XX | Yes
 |  |  |  |  |  |  | Obtained?
 |  |  |  |  |  |  | Opponents | Groups or Individuals
 |  |  |  |  |  |  |  | Reason for Opposition
 |  |  |  |  |  |  | Responsibilities | Design Engineering:
 |  |  |  |  |  |  |  | Inspections:
 |  |  |  |  |  |  |  | Construction or Project Management:
 |  |  |  |  |  |  |  | Service Monitoring:
 |  |  |  |  |  |  | Policy/Program Impact
 |  |  |  |  |  |  | Policy or Program
 |  |  |  |  |  |  | Emphasis
 |  |  |  |  |  |  | Change |  | XX | No |  | Yes
 |  |  |  |  |  |  | Operational
 |  |  |  |  |  |  | Impact
 |  |  |  |  |  |  | Assessment
 |  |  |  |  |  |  |  |  |  |  |  | (Continued on reverse side)
Details |  |  |  |  |  |  | Finances
 |  |  |  |  |  |  | City's Estimate
 |  |  |  |  |  |  | of Cost |  |  |  | $
 |  |  |  |  |  |  | Bid or | Lowest Contract
 |  |  |  |  |  |  | Proposal Data | Cost Submitted |  |  | $ | NA FOR
 |  |  |  |  |  |  |  | No .of Proposals Considered |  |  |  | AMENDMENT
 |  |  |  |  |  |  |  | Reason for rejecting lowest contract cost submitted
 |  |  |  |  |  |  |  | Other Bidders or |  |  |  | Contract Costs
 |  |  |  |  |  |  |  | Contractors Considered |  |  |  | Submitted
 |  |  |  |  |  |  |  |  |  |  | $ | NA FOR
 |  |  |  |  |  |  |  |  |  |  | $ | AMENDMENT
 |  |  |  |  |  |  |  |  |  |  | $
 |  |  |  |  |  |  |  |  |  |  | $
 |  |  |  |  |  |  |  |  |  |  | $
 |  |  |  |  |  |  |  |  |  |  | $
 |  |  |  |  |  |  |  |  |  |  | $
 |  |  |  |  |  |  |  |  |  |  | $
 |  |  |  |  |  |  |  |  |  |  | $
 |  |  |  |  |  |  |  |  |  |  | $
 |  |  |  |  |  |  |  |  |  |  | $
 |  |  |  |  |  |  |  |  |  |  | $
 |  |  |  |  |  |  |  |  |  |  | $
 |  |  |  |  |  |  |  |  |  |  | $
 |  |  |  |  |  |  | Fund Sources | 19__ Budget, Page ___
 |  |  |  |  |  |  | and Appropriation | Unbudgeted, Appropriation
 |  |  |  |  |  |  | Account Codes | ________________ Fund
 |  |  |  |  |  |  | For This | 00-000-00-0000-A0000
 |  |  |  |  |  |  | Contract
 |  |  |  |  |  |  | Source of
 |  |  |  |  |  |  | Future
 |  |  |  |  |  |  | Operating Funds
 |  |  |  |  |  |  | Maximum Amount
 |  |  |  |  |  |  | of Proposed
 |  |  |  |  |  |  | AMENDMENT |  |  |  | $
 |  |  |  |  |  |  | Amount of
 |  |  |  |  |  |  | Contingency |  |  |  | $
Estimated Duration of Contract: |  |  |  |  |  |  | Engineering &
 |  |  |  |  |  |  | Administration |  |  |  | $
Fact Sheet Prepared by: |  |  |  | Date: |  |  | TOTAL |  |  |  | $
Name
Title |  |  |  |  |  |  | Council Committee Actions
Reviewed by: |  |  |  | Date: |  |  | Do  Pass |  |  |  |  | Hold
Name
Title |  |  |  |  |  |  | Do Pass (as amended) |  |  |  |  | W/o Recommendation
Reference Numbers: |  |  |  |  |  |  | Committee Sub. |  |  |  |  | Do Not Pass