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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 11 /04/2019 <br />Name Roger Nawrot Department: Engineering <br />BPW Date 11/12/2019 Phone Extension 5932 <br />Required Prior to Submittal to Board <br />_........... ._-..__ _................. ..._..................... <br />BPW Attorney F] Attorney Name <br />Dept. Attorney 0 Attorney Name <br />Purchasing R <br />Check the Appropriate Item Tvve —,Reauired for All Submissions <br />LJ Professional Services Agreement H Contract <br />❑] Open Market Contract <br />❑ <br />Amendment/Addendum <br />❑ <br />Bid Opening <br />❑ <br />Bid Award <br />❑ <br />Quote Opening <br />E] <br />Quote Award <br />Proposal Opening <br />F <br />C/O & PCA No. <br />® Chg. Order, No. 11 <br />F-1 <br />Traffic Control <br />F-1 Other: <br />Required Information <br />L Proposal <br />Special Purchase, QPA <br />❑ Req. to Advertise ❑ Title Sheet <br />❑ Reject Bids/Quotes <br />PCA <br />Resolution <br />Ease./Encroach <br />Company or Vendor Name Larson Danielson Construction CoipTany,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 />Yes Lj If Yes, Approved by Purchasing <br />No <br />El MBE <br />❑ WBE Completed E-Verify Form Attached ❑ Nos <br />Howard Perk Redevel�nt & St Louis Boulevard Improvements <br />117-047B <br />Park Bond, RETIF, Regional Cities & Cumulative Capital <br />452.1101.452.02.03/429.1050.460.42.02/201.1111.452.42.01 /407.1101 <br />452.42.01 <br />Approval_ of C. Q. # 1 <br />For Change Orders Only <br />Amount of ® Increase $ 157,546.91 <br />❑ Decrease ($ <br />Previous Amount $ 18,,447„088.66 <br />Increase _._._ 0. 85.% ....... .. ..... _........ ....... .............���� __..W <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />New Completion Date: <br />Decrease <br />$ 18,604,635.57 <br />—Increase <br />Decrease <br />0 Days <br />12/15/2019 <br />1.15% <br />