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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 11-4-2022 <br />Name: Ken Smith Department of Public Works - Water Works <br />BPW Date: 11-08-2022 Phone Extension:6108 <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Michael Schmidt <br />Dept. Attorney Attorney Name Michael Schmidt <br />Purchasing Mickey Lovy <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: Ratify Quoted <br />Emergency Work <br /> Ease./Encroach <br />Required Information <br />Company or Vendor Name Premium Concrete Services <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 Emergency Repair – Cleveland Road Restoration after water valve repair <br />Project Number <br />Funding Source <br />Account No. 620-0640-606-439001 <br />Amount Original Estimate $52,865.00. Final Cost: $52,865.00 <br />Terms of Contract PO 19914 <br />Special Contract Provisions None <br />Purpose/Description A leaking water main valve required emergency repair on Cleveland Rd. <br />The street required restoration after the repair, specifically to County <br />standards. <br />For Change Orders Only <br />Amount of Increase <br />Decrease <br />$ <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: