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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 5/21/2019 <br />Department Public <br />Name Becca Plantz Works _ <br />w� <br />BPW Date 5/28/19 hone Extension 5998 <br />. <br />.�._.........._. �.....� <br />1 eqc iEd Prior to Submittal to Board_ <br />BPW Attorney® Attorney Name Clara McDanie���� <br />is <br />Dept. Attorney ❑] Attorney Name <br />Purchasing ❑ <br />_ Check the Ap K o ruts Item f' -�c._.. ?eqp <br />❑ <br />Professional Services Agreement Contract <br />Open Market Contract El Amendment/Addendum <br />[❑I <br />Bid Opening ❑ Bid Award <br />Quote Opening El Quote Award <br />Proposal Opening C/O & PCA No. <br />® <br />Chg. Order, No. 1 ❑ 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 />Li cLu ' qor All Submissions <br />Information <br />H Proposal <br />El Special Purchase, QPA <br />R Req. to Advertise <br />E, Reject Bids/Quotes <br />C] PCA <br />Resolution <br />oach <br />Ease...../Encr.... _ <br />❑ Title Sheet <br />Lump <br />.,lune o derwto cover additions itill , <br />... <br />_...... - _ _ ...... _ mm.---...... .... <br />For C 1�e Orders C�ly <br />Amount of Z <br />Increase $ 5,211 06 <br />Decrease ($ <br />Previous Amount <br />69.02 <br />Increase...... ._ ,... <br />4% <br />Current Percent of Change: <br />Decrease %) <br />New Amount <br />$ 136,280.08 _ ��� �....���e._ .. _,...�� .........................w —... �_ _..���........_. <br />..�,...��.�� ................���..—...�,�.........................ru..���.�.........._�....._.....��...................��.�__.....................�.....�.�.�. <br />._Increase <br />40% <br />Total Percent of Change: <br />Decrease %) <br />Time Extension Amount: <br />7 days „mm m <br />New Completion Date: <br />6/1/2019 <br />