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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 12/2/19www w <br />Name Alicia Czarnecki Department Engineer,in <br />BPW Date 12/10/19 Phone Extension 5903 <br />uired Prior to Submittal to Board <br />BPW Attorney ❑ Attorney Name <br />Dept. Attorney ❑I Attorney Name <br />Purchasing <br />Check the A <br />ro riate' Item 'f e - Rqq.Uh-edf6r All Submissions <br />❑]I Professional Services Agreement Contract ❑ Proposal <br />Open Market Contract <br />❑ Amendment/Addendum ❑ Special Purchase, QPA <br />Bid Opening <br />E" Bid Award [:] Req. to Advertise ❑ Title Sheet <br />F1 Quote Opening <br />El Quote Award Reject Bids/Quotes <br />E] Proposal Opening <br />[ C/O & PCA No. PCA <br />Chg. Order, No. <br />Traffic Control EJ Resolution <br />E] Other: <br />E] Ease./Encroach <br />tie aired Information <br />Company or Vendor Name <br />Ri%h-Riley Construction Co., Inc. <br />New Vendor <br />❑, Yes] If Yes, Approved by Purchasingw.. <br />❑ No <br />MBE/WBE Contractor <br />F] MBE Completed E-Verify Form Attached ❑ Nos <br />Project Name <br />Pinhook Park Site Improvements <br />...._.._._.... ..........a.... <br />Project Number <br />118-077A <br />Funding Source <br />Park Bond H & J, DNR Grant <br />Account No. <br />471-1136-452.42-01 / 471-1138-452.42-01 <br />Amount <br />$1,299,900.00 .�....���..�.____._.�.��.... ...... ..... ���.�_.��..._. <br />....._w .. .................. <br />Terms of Contract <br />_._._.... ......... <br />NTE <br />Purpose/Description <br />Construction of site improvement. . WWWWWWWWW <br />:sat Pinhook Park. <br />Amount of <br />$ <br />E] <br />Decrease <br />Decrease $ <br />Previous Amount <br />$ <br />Increase <br />Current Percent of Change: <br />Decrease <br />( % <br />New Amount <br />$ <br />Increase <br />_._..........% <br />Total Percent of Change: <br />Decrease <br />( % <br />Time Extension Amount: <br />New Completion Date: <br />������..............� <br />-------------- <br />