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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 08/25/2020 <br />Name Becca Plantz Department Public Works <br />BPW Date 09/08/2020 Phone Extension 5998 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance <br />and Inclusion Officer ❑ Officer Name Michael Patton <br />BPW Attorney ❑ Attorney Name Clara McDaniels <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ❑ <br />Check the Appropriate Item Type — Re uired or 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. 1 ❑ PCA <br />❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution <br />n Other: n Ease./Encroach <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Information <br />HRP Construction, Inc <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />❑ No <br />E] MBE ❑ WBE Completed E-Verify Form Attached ❑ Yes <br />❑ <br />Privet Lane Culvert Reblacement Project <br />118-013B <br />LRSA Mai or Proiects <br />251-00608-431.42-96, DFO PO-0000302 <br />Original: $264,471.00, Final: $260,587.78 <br />Unit Prices <br />—Completion of removing and replacing failing, existing culvert on Privet <br />Lane. <br />For Change Orders Only <br />Amount of ❑ Increase $ <br />® Decrease ($ 3,883.22) <br />Previous Amount <br />$ 264,471.00 <br />Increase <br />Current Percent of Change: <br />Decrease <br />New Amount <br />$ 260,587.78 <br />Increase <br />Total Percent of Change: <br />Decrease <br />Time Extension Amount: <br />90 days <br />New Completion Date: <br />6/30/2020 <br />