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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 8 14/ww2019 <br />Name Toy Villa <br />m_w <br />Department: Engineering <br />BPW Date 08/27/2019 Phone Extension 5920 <br />LAIbDPfflblG9mNl9®lN,i�t NGf�'/tl FNnYVWNIIX4fldYW <br />Board_ ____..................... .........1 <br />BPW Attorney], Attorney Name <br />Dept. Attorney <br />Purchasing <br />FE <br />Check the Arfty <br />Attorney Name <br />Item Tvne <br />0 Professional Services Agreement ❑ Contract <br />❑ Open Market Contract <br />f-I Amendment/Addendum <br />E Bid Opening <br />E] Bid Award <br />E Quote Opening <br />❑ Quote Award <br />Proposal Opening <br />® C/O & PCA No.l Final <br />Chg. Order, No. <br />Traffic Control <br />F-1 Other: <br />Information <br />Company or Vendor Name G.E. Marshall, Inc. <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 i Submssions <br />�Proposal <br />LJ Special Purchase, QPA <br />❑ Req. to Advertise ❑ Title Sheet <br />Reject Bids/Quotes <br />PCA <br />Resolution <br />Ease./Encroach <br />Yes❑ If Yes, Approved by Purchasing <br />No <br />MBE Completed E-Verify Form Attached Yes <br />No <br />Si all Diili.Il xgc Deslg!l.aiid Repair <br />118-063 <br />....�����.�.�.�.�.�.�.. �.................... .w__..�..�.,............__. <br />ExpenContractual Service .._.�....._..�....... <br />SSDA TIF /Utility..............ww�._..........�..._. <br />Expense/ Fund <br />430.1050.460.42.01 <br />Proiect Closeout <br />Amount .........:.:.. .......wm, �wm <br />For Chan Orders Only ... _ ... <br />t of Increase <br />Decrease ($ 18,521.47) <br />Previous Amount $ 135,628.00 <br />Increase m.. �....._......% <br />e: Decrease . <br />Current Percent of Chan .1..3.6...............6 <br />g (6% <br />New Amount $ 117,106.53 <br />Increase _% <br />Total Percent of Change: Decrease13.66% <br />Time Extension Amount: <br />New Completion Date: �.. _.m.m..m.m.............� �� ._._............._... <br />