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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 11/05/2019 <br />Department Public <br />Name Zach Hurst Works / Engineering <br />BPW Date 11/12/2019 Phone Extension 3057 <br />A. aired Prior to Submittal to Board <br />BPW Attorney Attorney Name <br />Dept. Attorney Attorney Name <br />Purchasing 0' <br />Check the A Ito rial It Tie W lea <br />El Professional Services Agreement Contract <br />EOpen Market Contract ® Amendment/Addendum <br />E] Bid Opening Bid Award <br />0' Quote Opening El Quote Award <br />❑ Proposal Opening E] C/O & PCA No. <br />❑ Chg. Order, No. F-1 Traffic Control <br />❑ Other: <br />Company or Vendor Name <br />Information <br />Architecture + Pl <br />All Submissions <br />LJ Proposal <br />Special Purchase, QPA <br />F� Req. to Advertise <br />❑ Reject Bids/Quotes <br />❑ PCA <br />Resolution <br />❑ Ease./Encroach <br />New Vendor U Yes" If Yes, Approved by Purchasing <br />�] No <br />MBE/WBE Contractor M WBE Completed E-Verify Form Attached <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Tech Resource Center <br />118-090 <br />River West TIF <br />324-1050-460-42.02 <br />$17,500.00 _............. <br />❑ Title Sheet <br />❑ Yes <br />❑ No <br />Amendment No. 3 for architectural desi gn and construction administration <br />services. <br />_v__ WWWWWW <br />For Change Orders Only <br />w <br />Amount of D area e ..... <br />...... <br />._ ._ ..... <br />_..... <br />ecrea <br />Previous Amount $ <br />Increase % <br />Current Percent of Change: Decrease ( % <br />New Amount $ <br />Increase % <br />Total Percent of Change: Decrease ( ... <br />Time Extension Amount:._.. <br />................... <br />New Completion Date: <br />