Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 7/7/2020 <br />Department <br />Name Sue Ellen Doudrick Engineering <br />BPW Date 7/14/2020 Phone Extension - <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 <br />Dept. Attorney Attorney Name <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 AwardRejectBids/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 NameSeitz Park Reconstruction Phase 1 <br />Project Number 117-093A <br />Funding Source Park Bond C, G, F, H and River East TIF <br />471-280-444000C, 471-284-444000G, 471-283-444000F, 471-285- <br />Account No.444000H, 429-444000 <br />Amount <br />Terms of ContractUnit prices <br />Purpose/DescriptionBid rejection due to divisions exceeding the allowable park bond limits. <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 />Time Extension Amount: <br />