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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 11/18/19 <br />Department Utilities - <br />Name Andrea AlexanderWastewater <br />....... _ ......... ..w_..�..............�............................. <br />BPW Date 11/26/19 Meetin Phone Extension 5813 <br />WNW emu wu�u mmmwamowm�ommmomwwmmmom <br />....... ......._.. ............ —...._ ............... <br />R Uired Prior to Submittal to Board _mm <br />BPW Attorney _ ® Attorney Name Clara Daniels <br />Dept. Attorney F-1 Attorney Name <br />__.__W ...................... <br />Purchasing 1:1w___w.... <br />Check the <br />Itemlyp l _gjr,irc j� All Submissions <br />M Professional Services Agreement E] Contract <br />❑ Open Market Contract n <br />Amendment/Addendum <br />Bid Opening E] <br />Bid Award <br />0 Quote Opening F-I <br />Quote Award <br />E] Proposal Opening F-1 <br />C/O & PCA No. <br />Chg. Order, No. [-� <br />Traffic Control <br />Other: <br />Information <br />Company or Vendor Name Cireel and Flansen, LLC <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 />J Proposal <br />E] Special Purchase, QPA <br />Req. to Advertise <br />❑ Reject Bids/Quotes <br />PCA <br />�] Resolution <br />Ease./Encroach <br />❑ Title Sheei <br />ICI Yeses If Yes, Approved by Purchasing <br />® No <br />❑ MBE ❑ Yes <br />❑ WBE ❑ No <br />Combined Sewer Overflow (CSO) Monthly Report of Operations (MRO) <br />Assistance <br />�.Wastewater &M ..... ._._._._.�.�. <br />641-0630-793-6335 <br />$9,900 <br />Technical assistance to update sophisticated spreadsheet used for CSO <br />Monthly Reporting <br />f._W..._ ...... .. <br />I For Change Orders <br />Amount of Increase Decrease $ <br />El($ _ j...._ ._............_ ._...������� �..... <br />Previous Amount <br />$........................................................... <br />Increase <br />% <br />Current Percent of Change: <br />Decrease <br />New Amount <br />$ <br />Increase <br />% <br />Total Percent of Change: <br />Decrease„mmm <br />% <br />Time Extension Amount: <br />___mmmmmmm <br />New Completion Date <br />