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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 8/14/19 <br />Department Public <br />Name Scott Kreeger <br />Works <br />BPW Date 8/27/19 <br />im.roaxxam.,awre i <br />Phone Extension 9245 <br />mmmmmm�omom mmummmmmuuuuuuummmwmmmimwmwxkru , <br />_.w..._—.—._ <br />..-...._.�.........-.... <br />... . ....... . . �..._.. <br />Required Prior to Submittal to Board <br />BPW Attorney ® <br />Attorney Name <br />.-.mom....®... <br />Clara McDaniels <br />Dept. Attorney <br />Attorney Name <br />Purchasing El <br />Michael Schmidt <br />................. ,... - ._....... ........ <br />Check the APPtoprit Item Tyre���rmml 1r*All Submissions <br />Professional Services Agreement <br />Contract <br />R Proposal <br />El Open Market Contract <br />❑ Amendment/Addendum E] Special Purchase, QPA <br />(] Bid Opening <br />❑ Bid Award <br />El Req. to Advertise ❑ Title Sheet <br />F] Quote Opening <br />❑ Quote Award <br />® Reject Bids/Quotes <br />❑ Proposal Opening <br />❑ C/O & PCA No. <br />❑ PCA <br />❑ Chg. Order, No. <br />❑ Traffic Control <br />Resolution <br />R Other: <br />Ease./Encroach <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 />gequired Information <br />[� Yes❑ If Yes, Approved by Purchasing <br />[� No <br />MBE Completed E-Verify Form Attached ❑ Nos <br />WBE <br />Notre Dame Triangle Alley Paving <br />.... _ �.. <br />119-057 <br />._ � . --- ......... .............. <br />LRSA� Repairs and Maintenance <br />.._..... _. P ...rs . <br />251-0608-431.23-02 <br />Reject all quotes due to budget limitations. Project will be requoted for a latf <br />date. <br />Amount of ❑ Increase $ <br />[� Decrease $ _. <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 % <br />Decrease ( % <br />