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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 07-11-2022 <br />Name: Jacob M. Klosinski Department of Public Works – Engineering Division <br />BPW Date: 07-26-2022 Phone Extension: 9496 <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Clara McDaniels <br />Dept. Attorney Attorney Name Clara McDaniels <br />Purchasing Michael Schmidt <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 Name Slatile Roofing & Sheet Metal Co., Inc. <br />New Vendor Yes If Yes, Approved by Purchasing <br /> No <br />MBE/WBE Contractor MBE <br />WBE Completed E-Verify Form Attached Yes <br />No <br />Project Name WWTP Masonry Improvements Gallery Buildings 1, 2, 3 and 4 <br />Project Number 120-036 (PROJ00000217; PO-00005683) <br />Funding Source 642-06-605-514-442005 <br />Account No. PO # 00005683 <br />Amount <br />Terms of Contract <br />Special Contract Provisions <br />Purpose/Description The Division of Engineering and Division of Utilities requests the Board of <br />Public Works approve the Final Completion Affidavit for the subject project. <br />All work is complete. Final Project cost was $440,704.00. <br />For Change Orders Only <br />Amount of Increase <br />Decrease <br />$ <br />($ ) <br />Previous Amount $ <br />Current Percent of Change: <br />Increase <br />Decrease <br />% <br />(%) <br /> New Amount $ <br />Total Percent of Change: <br />Increase <br />Decrease <br />% <br />(%) <br />Time Extension Amount: <br />New Completion Date: