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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 6/4/ 19 <br />Name Sean Ward/Larry Parker <br />Department <br />Streets <br />BPW Date 6/11/19 Phone Extension 7567 <br />Required Prior to Submittal to Board <br />._..._..._ ______- — <br />BPW Attorney Attorney Name <br />Dept. Attorney [J Attorney Name <br />Purchasing R Michael Schmidt <br />Lj Professional Services Agreement "Contract <br />Open Market Contract ❑ Amendment/Addendum <br />❑ <br />Bid Opening ❑ Bid Award <br />Quote Opening ® Quote Award <br />Proposal Opening ❑ C/O & PCA No. <br />Chg. Order, No. ❑ Traffic Control <br />Z Other: Retroactive Approval <br />- Einergency, Purchase Order <br />252164 — Self-,e Construction <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 />Amount of <br />Previous Amount <br />H Proposal <br />Special Purchase, QPA <br />E] Req. to Advertise ] Title Sheet <br />Reject Bids/Quotes <br />[� PCA <br />Resolution <br />EJ Ease./Encroach <br />Sedge Construction Co., Inc. <br />....... ....... _........... <br />E] Yes❑ If Yes, Approved by Purchasing <br />x No <br />0 MBE <br />❑ WBE Completed E-Verify Form Attached ❑ Nos <br />North Wellington Street Sewer Replacement <br />Sewage 0ps & Maintenance <br />641-0621-792.63 -3 5 <br />49,370.00 <br />Replace 220 linear feet of sewer line in the 1500 block of North <br />Wellington. Line is collapsed — residents are having recurring backups — <br />threat to Public Safety & Health. <br />�y Increase <br />Decrease <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />New Completion Date: <br />Ell <br />Increase <br />% <br />Decrease <br />( % <br />Increase...._.................��........ <br />__...%LL <br />Decrease <br />( % <br />