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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date July 3, 2019 <br />Name Kara Bovles <br />Department: Engineering <br />BPW Date July 9, 2019 Phone Extension 5933 <br />wuuu�uunnwn m� wr a ��r�ra n,�,arr�Neeexk. aawsmmrr� ... .� imm000mmmm�mm�mm�m0000m�mioioomurvurc�r�:tea <br />�,.�,... _........ ��....._..._ ............................. <br />� <br />q and Re uired Prior to Submittal to Bo _. w <br />BPW Attorney Attorney Name Clara McDaniels <br />Dept. Attorney ❑ Attorney Name <br />........ <br />Purchasing ❑ <br />Check the Appropriate Item Type Reuir <br />Professional Services Agreement Contract <br />Open Market Contract ❑ Amendment/Addendum <br />❑ Bid Opening ❑ Bid Award <br />❑ Quote Opening E] Quote Award <br />E] Proposal Opening F-1 C/O & PCA No. <br />Chg. Order, No. E] Traffic Control <br />Other: Restated and <br />uired Information <br />for All Submissions <br />❑ Proposal <br />❑ Special Purchase, QPA <br />Req. to Advertise ❑ Title Sheet <br />Reject Bids/Quotes <br />PCA <br />Resolution <br />❑ Ease./Encroach <br />or Name <br />p ySewer <br />St. �°��� � � an District <br />New VendorVen <br />mm <br />If Yes, Approved by �PurchasingWater <br />❑ No <br />MBE <br />MBE/WBE Contractor <br />Completed E-Verify Form Attached <br />❑ ❑ No <br />Project Name <br />Master Agreement <br />Project Number <br />N/A ...................................... mm.��............................................................�.�..........w <br />Funding Source <br />N/A <br />Account No. <br />_.......m......... ,,...... .................... ___.................................................................�. <br />N/A <br />Amount <br />..... ...... ..... ..... _ ,. ............. <br />N/A <br />Terms of Contract <br />Ten Years with automatic �.w....�........�_____ <br />renewalfor consecutive 10 years <br />Purpose/Description <br />A master agreement with the Regional SWD for the purpose of supplying <br />water and/or collection of sewerage as agreed to in separate addendums <br />related to sub -districts to be served by the RSWD. <br />For Change Ordersm On] y <br />Amount of F <br />Increase $ <br />[� <br />Decrease ($ ) <br />Previous Amount <br />$ <br />Increase <br />% <br />Current Percent of Change: <br />Decrease ( <br />% <br />New Amount <br />$ <br />.. Increase..,................................._w <br />Total Percent of Change: <br />Decrease ( <br />% <br />Time Extension Amount: <br />New Completion Date: <br />