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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 06/28/2019 y <br />Department Public <br />Name Zach Hurst Works <br />BPWDate 07/09/2019 w nmw��rm�wmawmsw�nm�, mr�umimu�wwwwwhimumimim Phone Extension 3057 <br />ar ,uwimwwu�W mmuuuuu�� amr�m rsn mrv; �m^u <br />1 r to Submittal to Board <br />BPW Attorney.� ......._ _ Attorney Name.._ ._��..........._ ...�................. ..... ��_ww <br />�] y <br />Dept. Attorney F Attorney Name <br />Purchasing <br />Check the AMto Iriate Item T e e t, <br />❑ Professional Services Agreement 0 Contract <br />Open Market Contract Amendment/Addendum <br />�] Bid Opening Bid Award <br />Quote Opening F1 Quote Award <br />0 Proposal Opening E] C/O & PCA No. <br />Chg. Order, No. El 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 />All Submissions <br />" Proposal <br />Special Purchase, QPA <br />® Req. to Advertise <br />❑ Reject Bids/Quotes <br />E] PCA <br />FI Resolution <br />[] Ease./Encroach <br />❑ Yes If Yes, Approved by Purchasing <br />E, No <br />® Title Sheet <br />TIF funded bid package containing 4 Divisions of work: Roof Overlay!, <br />Exterior.Masonry Rcoair and "oatin , Pa� Lot Re ���r and Re lace1nent. <br />and Electrical Work. <br />._. ...... w._ _..__ _ .. <br />For Change Orders Only <br />�.,. .mm�. .El www 4 M r � "r1 1 ��� <br />Amount of Decrease } t tI ie <br />Increase $ _ <br />�$ works <br />Previous Amount $ <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />New Completion Date: <br />Increase _ % <br />Decrease (" % <br />Increase ° o <br />Decrease ° <br />