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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 9/29/2020 <br />Name Becca Plantz Department Public Works <br />BPW Date 4 0/27/2020 Phone Extension 5998 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance ❑ Officer Name Michael Patton <br />and Inclusion Officer <br />BPW Attorney <br />❑ Attorney Name <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ❑ <br />Clara McDaniels <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 />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 />Black & Veatch Comoration <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />® No <br />❑ ❑ <br />MBE Completed E-Verify Form Attached ❑ Yes <br />No <br />North Water Treatment Plant Improvements <br />119-011 <br />River West TIF <br />PR-00004363 <br />$177,861.00 <br />Hourly not to Exceed <br />Design, bid, and construction phase services for North Water Treatment <br />Plant Improvements. <br />For Chance Orders Onl <br />Amount of ❑ Increase $ <br />❑ Decrease ($ ) <br />Previous Amount $ <br />Increase <br />Current Percent of Change: Decrease <br />New Amount $ <br />Increase <br />Total Percent of Change: Decrease <br />Time Extension Amount: <br />New Completion Date: <br />