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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date07/15/20 <br />Department <br />Name Alicia Czarnecki <br />Engineering <br />BPW Date07/28/20 Phone Extension 5903 <br /> <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance <br /> Officer Name <br />and Inclusion Officer <br />BPWAttorney Attorney Name <br />Dept. Attorney Attorney Name <br /> <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. PCA <br /> Chg. Order, No. 2 Traffic Control Resolution <br /> Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name Larson-Danielson Construction Company, Inc. <br /> Yes If Yes, Approved by Purchasing <br />New Vendor <br /> No <br /> MBE MBE MBE <br />MBE/WBE Contractor <br /> WBE WBE WBE <br />Project Name Pinhook Park Pavilion Improvements <br />Project Number 118-077B <br />Funding Source Park Bond H & J, DNR Grant <br />Account No. 471-1136-452.42-01 / 471-1138-452.42-01 <br />Amount <br />Terms of Contract NTE <br />Purpose/Description _Interior renovation of the existing pavilion at Pinhook Park.______________ <br />For Change Orders Only <br />$ 7,676.00 <br /> Increase <br />Amount of <br /> Decrease ($ ) <br />Previous Amount $ 177,367.23 <br />4.33% <br />Increase <br />Decrease ( %) <br />Current Percent of Change: <br /> <br />New Amount $ <br />12.44% <br />Increase <br />Decrease ( %) <br />Total Percent of Change: <br /> <br />Time Extension Amount: 0 <br />New Completion Date: <br /> <br />