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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 04/03/2020 <br />Department Public <br />Name Toy Villa Works <br />BPW Date 04/14/2020 Phone Extension 5920 <br />Required Prior to Submittal to Board <br />BPW Attorney ❑ Attorney Name <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ❑ <br />Check the Appropriate Item Type — Required. for All Submissions <br />❑ Professional Services Agreement ❑ Contract ❑ Proposal <br />❑ Open Market Contract ❑ Amendment/Addendum ❑ Special Purchase, QPA <br />❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening ❑ Quote Award ❑ Reject Bids/Quotes <br />❑ Proposal Opening ® C/O & PCA No. l Final ❑ PCA <br />❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution <br />n Other: n Ease./Encroach <br />Information <br />Company or Vendor Name <br />Slatile Roofing and Sheet Metal Co., Inc. <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />New Vendor <br />® No <br />Yes <br />MBE <br />MBE/WBE Contractor <br />Completed E-Verify Form Attached <br />❑ ❑ No <br />Project Name <br />Vietnam Veterans Memorial Relocation <br />Project Number <br />117-047A <br />Funding Source <br />Regional Cities Grant <br />Account No. <br />201.1111.452.31.06 <br />Amount <br />$ <br />Terms of Contract <br />Purpose/Description <br />Project Closeout. <br />For Change Orders Only <br />Amount of ❑ Increase $ <br />® Decrease ($ 3,000.00) <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />New Completion Date: <br />$ 152,850.00 <br />Increase <br />% <br />Decrease <br />(1.96%) <br />$ 149,850.00 <br />Increase <br />% <br />Decrease <br />(1.96%) <br />