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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 04/17/2020 <br />Name Toy Villa Department Engineering <br />BPW Date 04/28/2020 Phone Extension 5920 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance <br />and Inclusion Officer ❑ Officer Name <br />BPW Attorney ❑ Attorney Name <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ❑ <br />Check the Appropriate Item Type — Re uired or 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 [3 C/O & PCA No. 1 ❑ PCA <br />❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution <br />n Other: n Ease./Encroach <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 />Information <br />Rieth Riley Construction Co., Inc <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />❑ No <br />E] MBE ❑ WBE Completed E-Verify Form Attached ❑ Yes <br />❑ <br />Gemini Site Imbrovements <br />119-043 <br />WWDA TIF <br />422.1050.460.42.02 <br />Proj ect <br />Closeout <br />For Change Orders Only <br />Amount of ❑ Increase $ <br />® Decrease ($ 15,888.00) <br />Previous Amount <br />$ 614,451.28 <br />Increase <br />Current Percent of Change: <br />Decrease <br />New Amount <br />$ 598,563.28 <br />Increase <br />Total Percent of Change: <br />Decrease <br />Time Extension Amount: <br />New Combletion Date: <br />2.59% <br />2.59%) <br />