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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 01/6/20 <br />........... _ .... <br />Name Alicia Czarnecki Department En <br />BPW Date 01/14/20 Phone Extension 5903 <br />Review and Aprbvairel Prior to Submittal to Board <br />Diversity Compliance ❑ Officer Name <br />and Inclusion Officer <br />BPW Attorney El Attorney Name <br />Dept. Attorney F-1 Attorney Name <br />Purchasing <br />Check the ) riate Item T si ir, <br />❑ Professional Services Agreement Contract <br />❑ Open Market Contract ❑ Amendment/Addendum <br />Bid Opening ® Bid Award <br />F] Quote Opening ❑ Quote Award <br />Proposal Opening ❑ C/O & PCA No. <br />Chg. Order, No. ❑ Traffic Control <br />❑ Other: <br />All Submissions <br />Proposal <br />Special Purchase, QPA <br />Req. to Advertise <br />Reject Bids/Quotes <br />PCA <br />❑', Resolution <br />❑ Ease./Encroach <br />❑ Title Sheei <br />Company or Vendor Name <br />Gibson -Lewis, LLC <br />❑ Yes❑ If Yes, Approved by Purchasing <br />New Vendor <br />No <br />MBE <br />MBE/WBE Contractor <br />Completed E-Verify Form Attached <br />� ❑ Nos <br />Project Name <br />Morris....... TheaterPlaster Repair <br />Project Number <br />118 0944R <br />Funding Source <br />....... <br />Capital Improvements/Building Improvements <br />Account No. <br />416-0404-453.42-02 <br />Amount <br />$333,224.00 <br />Terms of Contract <br />NTE........ <br />Purpose/Description <br />es mes at <br />Restoration work of the plaster frieze at the perimeter of four dom <br />Morris Performing Arts Center. <br />For Change Orders Oil <br />Amount of <br />Increase $ <br />Decrease $ <br />Previous Amount <br />$ .......... . ............ _..� ................._... <br />IncreaSe <br />Current Percent of Change: <br />Decrease _� %) <br />New Amount <br />$ <br />Increase % <br />Total Percent of Change: <br />Decrease % <br />Time Extension Amount: <br />New Completion Date: <br />