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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 07/20/2020 <br />Department Engineering <br />Name Toy Villa <br />BPW Date 07/28/2020 Phone Extension 5920 <br />Required Prior to Submittal to Board <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 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. Traffic Control Resolution <br /> Other: Ease./Encroach <br />Required Information <br />Company or Vendor NameBrown & Brown General Contractors, Inc. <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 Name Edison Filtration Plant Roof Replacement <br />Project Number 119-014 <br />Funding SourceWater Capital -Building Improvements <br />Account No. 622-0640-415.42-02 <br />Amount$476,655.15 <br />Terms of Contract <br />Purpose/Description Project Closeout <br />For Change Orders Only <br />$ <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 />New Completion Date: <br />