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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date April 22019, <br />Department Public <br />Name Scott Kreeger Works <br />........... <br />BPW Date A ri19 2019 Phone Extension 9245 <br />M <br />I uir Prior to Submittal to Board <br />BPW Attorney ❑' Attorney Name �C."late McDa�riel <br />Dept. Attorney [l Attorney Name <br />....... <br />Purchasing M Michael Schmidt <br />Item Twe <br />LJ Professional Services Agreement ❑ Contract <br />❑ Open Market Contract ❑ Amendment/Addendum <br />Bid Opening ❑ Bid Award <br />❑ Quote Opening El Quote Award <br />❑ Proposal Opening [] C/O & PCA No. <br />[1 Chg. Order, No. Traffic Control <br />n 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 />Information <br />Proposal <br />❑ Special Purchase, QPA <br />® Req. to Advertise ❑ Title Sheet <br />Reject Bids/Quotes <br />E] PCA <br />Resolution <br />Ease./Encroach <br />s If Yes A roved b Purchas � - ❑ ❑ Pp Y ing ----- <br />No — <br />❑ MBE Completed E-Verify Form Attached ❑ Yes <br />❑ WBE ❑ No <br />DIP + Valves +Hydrants Material Bid <br />119-034 ..�.. ....... <br />Water Works Operations <br />620-0640-606.23.62 <br />Purpose/Description R <br />..... _ �... ..... . ... __ _..... <br />oast to Advertise for du�aile iron i e valves and h drants for Ghc wata <br />works department. lst Advertisement on April 19 2019.and 2nd Adv rtiserne <br />on April 26, 2019 <br />Amount of Increase $ <br />nf- <br />Decrease $ __ I� � °n- <br />.. _ ...... ....... _ <br />Previous Amount <br />Increase <br />Current Percent of Change: Decrease <br />New Amount $ „ <br />_..M....�_ _ ...... <br />Increase % <br />........ _ _... <br />Total Percent of Change: Decrease <br />Time Extension Amount: <br />New Completion Date: <br />