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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date June 18 2019 <br />Name Sandra Kennedy <br />,,,,,,,. ......................._ p <br />De artment Legal on behalf of DCI and VPA <br />BPW Date June 25 2019 Phone Extension 235-9294 <br />�r,. 000mmmmmmnmmm�mmmmmimimmm owmioi000000000mmmmmmmmmmmmmmmmmmmmmmmm moionmrnm; nmuummmmuuuuuuuuuuuuuuuuuuuuumuummmuwimmwawaamwma w wmwwomomomO <br />Required Prior to Submittal to Board <br />BPW Attorney Attorney Name Clara McDaniels <br />Dept. Attorney Attorney Name Sandra Kennedy <br />. .................. ..�� <br />Purchasing �] <br />Check theAprc�uate Item 1' �tmr <br />.— ........... <br />Professional Services Agreement JZ Contract <br />❑ Open Market Contract ❑ Amendment/Addendum <br />Bid Opening ❑ Bid Award <br />Quote Opening Quote Award <br />Proposal Opening ❑ C/O & PCA No. <br />Chg. Order, No. ❑ Traffic Control <br />Other: <br />Information <br />All Submissions <br />Proposal <br />El Special Purchase, QPA <br />El Req. to Advertise <br />Reject Bids/Quotes <br />❑ PCA <br />Resolution <br />Ease./Encroach <br />❑ Title Sheei <br />Company or Vendor Name <br />FREG Central Higi1Associates <br />_.. ._................ <br />E] Yes❑ If Yes, Approved by Purchasing ...._....... .. - <br />New Vendor <br />F-] No <br />MBE/WBE Contractor <br />WBE Completed E-Verify Form Attached ❑ Nos <br />Project Name <br />Seitz Park Improvements <br />_. ��������.�. .......... „m ....... <br />Project Number <br />117-093 <br />Funding Source <br />Account No. <br />Amount <br />$ 0 <br />Terms of Contract <br />� � �� ....._.....� ...... . <br />Real Property Interest Terminations <br />Purpose/Description <br />Easement Termination Agreement: While there are no easements of record <br />nor are there any City utilities on this site, Central High Associates' attorne <br />has asked for this document to be executed by all City entities. The intent i <br />to terminate any easements not found in a title search. <br />_ <br />For Change OrdersQnl m <br />_...�� .� <br />Am�....._...wwww <br />Increase $ <br />Decrease$ <br />Previous Amount <br />$ ................._.._.........._._.... <br />Increase �0 ....__m..�................................... <br />.�............ <br />Current Percent of Change: <br />............ ..... .. <br />Decrease /o) <br />. <br />New Amount <br />.... <br />$ <br />Increase /o <br />Total Percent of Change: <br />Decrease ( %) <br />Time Extension Amount: <br />