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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 8/31/2020 <br />Name Leslie Biek, PE <br />Department Engineering <br />BPW Date 9/8/2020 <br />Phone Extension <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance ❑ <br />and Inclusion Officer <br />Officer Name <br />BPW Attorney ❑ <br />Attorney Name <br />Dept. Attorney ® <br />Attorney Name <br />Clara McDaniels <br />Purchasing ❑ <br />Check the Appropriate <br />Item Type <br />— Required for All Submissions <br />❑ Professional Services Agreement <br />❑ Open Market Contract <br />❑ Bid Opening <br />❑ Quote Opening <br />❑ Proposal Opening <br />❑ Chg. Order, No. <br />❑ Other: <br />® Contract ❑ Proposal <br />❑ Amendment/Addendum ❑ Special Purchase, QPA <br />❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Award ❑ Reject Bids/Quotes <br />❑ C/O & PCA No. ❑ PCA <br />❑ Traffic Control ❑ Resolution <br />❑ Ease./Encroach <br />Reauired Information <br />Company or Vendor Name <br />Norfolk and Southern <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />New Vendor <br />® No <br />Yes <br />MBE <br />MBE/WBE Contractor <br />Completed E-Verify Form Attached <br />❑ ❑ No <br />Project Name <br />Olive Reconstruction Ph 2 <br />Project Number <br />114-064 <br />Funding Source <br />RWDA TIF <br />Account No. <br />324-10-102-121-442001 <br />Amount <br />$7,447 <br />Terms of Contract <br />Starting 7/1/2020 until complete <br />Purpose/Description <br />This is an agreement stating the City will reimburse the Railroad costs for <br />engineering review of the Olive Ph 2 plans. <br />For Change Orders Only <br />Amount of ❑ <br />Increase $ <br />❑ <br />Decrease ($ ) <br />Previous Amount <br />$ <br />Increase % <br />Current Percent of Change: <br />Decrease ( %) <br />New Amount <br />$ <br />Increase % <br />Total Percent of Change: <br />Decrease ( %) <br />Time Extension Amount: <br />New Combletion Date: <br />