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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />�MIF <br />04/06/2020 <br />Alicia Czarnecki <br />Department <br />Division/Bureau <br />Public Works <br />Engineering <br />BPW Date 04/14/2020 Phone Extension 5903 <br />Required Prior to Submittal to Board <br />Legal ❑ Attorney Name: <br />Controller ❑ Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing ❑ <br />Check the Appropriate Item Type — Required for All Submissions <br />❑ Agreement ❑ Contract ❑ Proposal ❑ Addendum <br />® Professional Services ❑ Resolution <br />❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening ❑ Quote Award <br />❑ Change Order No. ❑ C/O & PCA No. ❑ PCA <br />❑ Ease/Encroach. ❑ Traffic Control: <br />ICI Other: Amendment No. 2 <br />Required Information <br />Company or Vendor Name Lawson -Fisher Associates P.C. <br />❑ Yes ® No ❑ If Yes, Approved by <br />New Vendor Purchasing <br />MBE/WBE Contractor ❑ MBE ❑ WBE <br />MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Olive Street Reconstruction <br />114-064 <br />RWDA TI F <br />324-1050-460.31-02 <br />$14,525.00 <br />Not to Exceed <br />Purpose/Description The Amendment No. 2 is for separating this project into two <br />construction phases, and associated design and plan <br />development, utility coordination services, and right-of-way plan <br />development. <br />❑ Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Required For Change Orders Only <br />Amount of ❑ Increase $ <br />❑ Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Chanae: % <br />