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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date September 25 2019 <br />Department Public <br />Name Scott Kreeger �m............- Works <br />BPW Date October S 2019 Phone Extension 9245 <br />. _...._..... .___..._. <br />Required, Prior to Submittal to Board <br />BPW Attorney ® Attorney Name Clara McDaniels <br />Dept. Attorney Q Attorney Name <br />Purchasing Michael Schmidt <br />Check the Appropriate Item Type -- <br />Professional Services Agreement n Contract <br />Open Market Contract <br />® Amendment/Addendum <br />Bid Opening <br />❑ Bid Award <br />Quote Opening <br />❑ Quote Award <br />❑ Proposal Opening <br />E] C/O & PCA No. <br />Chg. Order, No. <br />n 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 />Information <br />All Submissions <br />LJ Proposal <br />R Special Purchase, QPA <br />Req. to Advertise <br />Reject Bids/Quotes <br />❑ PCA <br />❑ Resolution <br />Ease./Encroach <br />❑ Title Sheet <br />The Troyer +C xrou, Inc. <br />Yes❑ If Yes Approve.._ .......r _�.�...._ �.� ������.....�... <br />d by Purchasing <br />No <br />F] MBE Completed E-Verify Form Attached Yes <br />WBE No <br />2018 FI Dp�m.aq, wars East Bank and East Race Re airsmm <br />118-305 <br />Streets and Alleys mm <br />226-0419-672.42-03 <br />$40,387 <br />Lump Sum <br />PSA amendment to increase the agree nent amount by $6 185.00 for -a <br />new total of $40 387 <br />Amount of Increase $ m. <br />Decrease $ <br />.................. .....�.�. <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 />% <br />Decrease <br />( % <br />................. .........��...............................ww�.____.......__ <br />Increase <br />% <br />Decrease <br />l % <br />