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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 11-01-2022 <br />Name: Sarah Beam Department of Public Works – Engineering Division <br />BPW Date: 11-8-2022 Phone Extension: 9805 <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Michael Schmidt <br />Dept. Attorney Attorney Name Michael Schmidt <br />Purchasing Michael Schmidt / Ron O'Connor <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 <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 Sewer and Manhole Rehabilitation <br />Project Number 122-019 (PROJ00000299; PR-00020477) <br />Funding Source Sewage Works Capital <br />Account No. PR-00020477 (642-509-442003; Sewage Works Capital) <br />Amount <br />Terms of Contract <br />Special Contract Provisions <br />Purpose/Description The Division of Engineering requests the Board of Public Works approval of a <br />Request to Advertise for Public Bid Project No. 122-019 Sewer and Manhole <br />Rehabilitation. Refer to Memorandum for proposed Bidding Schedule. <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: <br />November 8, 2022