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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date08/28/2020 <br />DepartmentDPW <br />NameZach Hurst <br />BPW Date09/08/2020Phone Extension3057 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance <br />Officer Name <br />and Inclusion Officer <br />BPWAttorneyAttorney 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 ContractAmendment/Addendum Special Purchase, QPA <br />Bid OpeningBid AwardReq. to AdvertiseTitle Sheet <br />Quote OpeningQuote AwardReject Bids/Quotes <br />Proposal OpeningC/O & PCA No. PCA <br />Chg. Order, No. 1Traffic ControlResolution <br />Other: Ease./Encroach <br />Required Information <br />Company or Vendor NameJ. W. Werntz & Son, Inc. <br />YesIf Yes, Approved by Purchasing <br />New Vendor <br />No <br />MBEYes <br />MBE/WBE ContractorCompleted E-Verify Form Attached <br />WBE No <br />Project NameKizer Mansion Window Repair <br />Project Number 119-024 <br />Funding SourceWWDA TIF <br />Account No.422-10-102-121-443001 <br />Amount$21,000.00 <br />Terms of Contract <br />Purpose/DescriptionDeduct change order to address sill modifications. <br />For Change Orders Only <br />$ <br />Increase <br />Amount of <br />Decrease($21,000.00) <br />Previous Amount$218,000.00 <br />% <br />Increase <br />Decrease(9.63%) <br />Current Percent of Change: <br />New Amount$197,000.00 <br />% <br />Increase <br />Decrease(9.63%) <br />Total Percent of Change: <br />Time ExtensionAmount:0 days <br />New Completion Date:9/30/2020 <br />