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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br /> <br />Date 9/13/2022 <br />Name Leslie Biek, PE Department PW <br />BPW Date 9/27/2022 Phone Extension 9323 <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 <br />Sheet <br /> Quote Opening Quote Award Reject Bids/Quotes <br /> Proposal Opening C/O & PCA No. PCA <br /> Chg. Order, No. 1 and Final Traffic Control Resolution <br /> Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name Midland Engineering Company, 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 SBPD Roff Rehabilitation and Replacement <br />Project Number 119-080 <br />Funding Source Escrow lease <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description Final balancing change order for the project. Change order includes <br />additional curb caps for pate rails and additional wall panel roof system <br />removal. <br />For Change Orders Only <br />Amount of <br /> <br />Increase <br />Decrease <br />$ 27,100.00 <br />($ ) <br />Previous Amount $ 1,268,400.00 <br />Current Percent of Change: <br />Increase <br />Decrease <br />2.14% <br />( %) <br /> New Amount $ 1,295,500.00 <br />Total Percent of Change: <br />Increase <br />Decrease <br />2.14% <br />( %) <br /> Time Extension Amount: <br />New Completion Date: