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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br /> <br />Date 07/06/2022 <br />Name Toy Villa Department Public Works <br />BPW Date 07/26/2022 Phone Extension 5920 <br /> <br />Review and Approval Required Prior to Submittal to Board Diversity Compliance <br />and Inclusion Officer Officer Name BPW Attorney Attorney Name <br />Dept. Attorney Attorney Name <br /> <br />Purchasing <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. 1 <br /> <br /> PCA <br /> Chg. Order, No. Traffic Control Resolution <br /> Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name Selge Construction 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 Studebaker Fountain Water Improvements <br />Project Number 121-032 <br />Funding Source Fund 201 Park Capital; and Fund 452 Land Improvements <br />Account No. 201-273-443001; and 452-444000 <br />Amount $150,913.00 <br />Terms of Contract <br />Purpose/Description Project Closeout <br />For Change Orders Only <br />Amount of <br /> <br />Increase <br />Decrease <br />$ <br />($ 7,527.50) <br />Previous Amount $ 158,440.50 <br />Current Percent of Change: <br />Increase <br />Decrease <br /> % <br />(4.75%) <br /> New Amount $ 150,913.00 <br />Total Percent of Change: <br />Increase <br />Decrease <br /> % <br />(4.75%) <br /> Time Extension Amount: <br />New Completion Date: