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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 05/05/2020 <br />Department Public Works <br />Name Becca Plantz <br />BPW Date 05/12/2020 Phone Extension 5998 <br /> <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance <br />Officer Name <br />and Inclusion Officer <br />BPW Attorney Attorney Name Clara McDaniels <br />Dept. Attorney Attorney Name <br /> <br />Purchasing <br />Check the Appropriate Item Type – Required for All Submissions <br />Professional Services AgreementContractProposal <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 OpeningC/O & PCA No. PCA <br />Chg. Order, No. Traffic Control Resolution <br />Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name <br />Yes If Yes, Approved by Purchasing <br />New Vendor <br />No <br />MBE Yes <br />MBE/WBE Contractor Completed E-Verify Form Attached <br />WBE No <br />Project NameBendix Theater Esports Arena <br />Project Number 119-106C <br />Funding Source Hotel Motel Tax Fund <br />Account No. 7304.42010.000.0099 <br />Amount <br />Terms of ContractLump Sums <br />Construction andinstallation ofequipment to make improvements to Bendix <br />Purpose/Description <br />Theater and Century Center for eSports Gaming Center and Broadcast <br />Studio. <br />For Change Orders Only <br />$ <br /> Increase <br />Amount of <br /> Decrease ($ ) <br />Previous Amount$ <br />% <br />Increase <br />Decrease ( %) <br />Current Percent of Change: <br /> <br />New Amount $ <br />% <br />Increase <br />Decrease ( %) <br />Total Percent of Change: <br /> <br />Time Extension Amount: <br />New Completion Date: <br /> <br /> <br />