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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />December 17, 2019 <br />Kara Bovles <br />Department Engineer <br />BPW Date December 19 2019 Phone Extension 5933 <br />n 111111E nnnnnnn <br />,eeluired Prior to Submittal to Board <br />BPW Attorney ® Attorney Name Clara McDaniels <br />Dept. Attorney ❑ Attorney Name <br />. ................. <br />Purchasing F I <br />Check the Appropriate Item Type --- <br />❑ Professional Services Agreement F] Contract <br />E] Open Market Contract <br />® <br />Amendment/Addendum <br />❑ Bid Opening <br />Bid Award <br />Quote Opening <br />Quote Award <br />Proposal Opening <br />EJ <br />C/O & PCA No. <br />Chg. Order, No. <br />Traffic Control <br />Other: <br />Required Information <br />o <br />All Submissions <br />Proposal <br />LJ Special Purchase, QPA <br />Req. to Advertise <br />Reject Bids/Quotes <br />(� PCA <br />❑ Resolution <br />Ease./Encroach <br />❑ Title Sheel <br />Company or Vendor Name St Joseph Colwnt <br />. _.___._____._ . <br />For lyini OrdersmmOnl ...... w <br />Amount of Increase $ <br />Decrease ($ ) <br />New Vendor <br />Yes If Yes, Approved by Purchasing <br />® No <br />MBE/WBE Contractor <br />❑WBE Completed E-Verify Form Attached ❑Nos <br />Project Name <br />Amendment to MOU for Portage Avenue Bridge Replacement <br />Project Number <br />ITSecond <br />17J025 <br />Funding Source <br />RWDA T IF/LRSA <br />Account No. <br />324-1050-4 0. .__ ........._ _�� <br />6 42-03 / 251-0608-431.42-96 <br />Amount <br />Total $62 846.80 (Increase of $892.65 for final closeout items <br />Terms of Contract <br />Pa�nnent will be made once approved by BPW <br />Purpose/Description <br />City's cost adjustment related to requested elements of work aspartof the <br />County's project to replace the Portage Avenue Bridge. <br />Previous Amount $ _ <br />Increase ° <br />_ <br />�o <br />Current Percent of Change: Decrease (...._._........% <br />New Amount $ <br />Increase ..._�..���.�..��.�......._ w o <br />�o <br />Total Percent of Change: Decrease ( 0/,o <br />Time Extension Amount: ..........._. <br />New Completion Date: <br />