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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 2/18/2020 <br />Name Zach Hurst Department DPW <br />BPW Date 2/25/2020 Phone Extension 3057 <br />mmnnonmm mmm <br />'Review and A rival R� oir�� Prior:. to Submittal'to Board <br />Diversity Compliance ® Officer Name <br />and Inclusion Officer <br />BPW Attorney� Attorney Name Clara McDanie y is and Aladean DeRose <br />Dept. Attorney <br />Purchasing <br />[� Attorney Name <br />N1 <br />LJ Professional Services Agreement H Contract <br />EJ Open Market Contract ❑ Amendment/Addendum <br />Bid Opening Bid Award <br />❑ Quote OpeningQuote Award <br />❑ Proposal Opening C/O & PCA No. <br />Chg. Order, No. Traffic Control <br />❑ Other: <br />.. _ .. W� <br />Rectuired Informati <br />Company or Vendor Name <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 />ons <br />L j Proposal <br />Special Purchase, QPA <br />Req. to Advertise ❑ Title Sheei <br />❑ Reject Bids/Quotes <br />PCA <br />E] Resolution <br />F� Ease./Encroach <br />w s If .. __ __................... <br />�❑ ❑ Yes, Approved by Purchasing <br />No <br />MBE Completed E-Verify Form Attached ❑❑ Nos <br />WBE <br />Gemini at Colfax — Exterior Renovations <br />119-103 <br />w ....._................ <br />RWDA TIF, WWDA TIF <br />324-1050-460-42.02; 422-1050-460-42.02 <br />Divisible bid 12ackage containing 5 divisions: roof re air masonry repairs. <br />window repit <br />eernent fire stair replacement, and water main installation. <br />Amount of H Increase $ <br />Decrease ($ <br />Previous Amount $ <br />......... ...................... <br />Increase <br />Current Percent of Change: Decrease <br />New Amount $ _ <br />Increase <br />Total Percent of Change: Decrease <br />Time Extension Amount:. <br />New Completion Date: <br />