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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date8/08/2019.........._._..........................�.�.�.�............ _. <br />Department Public <br />Name Tov Villa Works <br />BPW Date 8/27/2019 Phone Extension 5920 <br />_..__.� _.......... _— ................. ._.......... ......... .. <br />required Prior to Submittal to Board <br />BPW Attorney Attorney Name <br />Dept. Attorney F Attorney Name <br />Purchasing ❑ <br />Check the A °o )ri�ate Item Ty a ldc"mta <br />F] Professional Services Agreement [:] Contract <br />n''' Open Market Contract ❑ Amendment/Addendum <br />0 Bid Opening ❑ Bid Award <br />Quote Opening ❑ Quote Award <br />❑ Proposal Opening ❑ C/O & PCA No. <br />EJ Chg. Order, No. ❑ 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 />LAB )r All Submissions <br />Information <br />H Proposal <br />El Special Purchase, QPA <br />Req. to Advertise <br />[� Reject Bids/Quotes <br />® PCA <br />❑ Resolution <br />Ease./Encroach <br />Ritschard Bros., Inc. <br />nYes❑ If Yes, Approved by Purchasing <br />No <br />[� MBE Completed E-Verify Form Attached <br />❑ WBE <br />320 at the Cascade — Site Utilities, Division B <br />74D, Div. B <br />RiverEast...T.I.F.................�...._._..... �... ,,,,,,....._�... �.�...�.�.�.�.�...�.�........_...�_.... <br />429.1050.460.42.02............. �Y __... ......................�.�.�.�. <br />$53,487.00................�.��—��� ....... <br />Prc ie t - o§gout. <br />❑ Title Sheet <br />❑ Yes <br />❑ No <br />— _ ......_ .... ._. ..� <br />ww. __vvvvvv _.— ..m. ..... For C]tie Orders�aly m.. <br />Amount of Increase $ <br />[� Decrease — .��... <br />Previous Amount $ <br />Current Percent of Change: <br />New Amount <br />Increase _% <br />Decrease ( % <br />Increase % <br />Total Percent of Change: Decrease (mmmmm mmm w% <br />Time Extension Amount: <br />New Completion Date: <br />