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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 05/20/19 <br />Name Alicia Czarnecki Department EnEineerin2 <br />BPW Date 05/2 /19 Phone Extension 5903 <br />iiiiiiiiiiiiiiiiiiiiiillillillillillillilliillillillillillillilliilliwEinim <br />Rc uir d Prior to Submittal to Board <br />BPW Attorney ® Attorney Name <br />Dept. Attorney Z Attorney Name <br />Purchasing � � v ,,�.� �.� �_....................................... <br />Check the <br />Professional Services Agreement <br />Open Market Contract <br />❑ Bid Opening <br />❑ Quote Opening <br />E] Proposal Opening <br />Chg. Order, No. <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 />ate Item _mm e —. <br />Contract <br />u/r e d`w w All Submissions <br />EI Amendment/Addendum <br />Z Bid Award <br />Quote Award <br />C/O & PCA No. <br />❑ Traffic Control <br />Information <br />L] Proposal <br />Special Purchase, QPA <br />❑ Req. to Advertise <br />E] Reject Bids/Quotes <br />PCA <br />Resolution <br />Ease./Encroach <br />❑ Title Sheet <br />Rieth-RielyConstruction Co., Inc. <br />Yes If Yes, Approved by Purchasing <br />No <br />MBE MBE Completed E-Verify Form Attached Nos <br />2019 Curb & Sidewalk Construction <br />119-004 <br />MVH <br />202-0619-431.31-06 _ <br />$394,628.50 (Divisions Al, B1, C1, C2, D1, and Altern mmmmmm ate2 <br />Unit Price Not to Exceed <br />Purpose/Description Award Divisions Al, B1, Cl, C2, D1, and Alternate 2, of 2019 Curb and <br />Sidewalk Program. <br />For Change Orders Only <br />�....._ . �m .. .._........�....._.�. ��._.�� ... ...... ....... _�.. <br />Amount of Increase $ <br />[❑ Decrease ($ ) <br />Previous Amount <br />$ <br />Increase <br />% <br />Current Percent of Change, <br />Decrease <br />(..v <br />New Amount <br />$ <br />Increase <br />% <br />Total Percent of Change: <br />Decrease <br />( % <br />Time Extension Amount: <br />New Comx)letion Date: <br />