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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 12/15/2022 <br />Name Zach Hurst Department DPW <br />BPW Date 12/20/2022 Phone Extension 3057 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance <br />and Inclusion Officer Officer Name <br />BPW Attorney Attorney Name <br />Dept. Attorney Attorney Name <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. PCA <br /> Chg. Order, No. 1 Traffic Control Resolution <br /> Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name Gibson-Lewis <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 Four Winds Field Player Facilities Improvements <br />Project Number 122-021 <br />Funding Source PSCDA Fund <br />Account No. PO-0019560 <br />Amount $34,787.00; Revised Amount: $1,382,787.00 <br />Terms of Contract <br />Purpose/Description Change Order 1 covering athletic flooring removal, electrical work, and <br />conduit relocation <br />For Change Orders Only <br />Amount of Increase <br />Decrease <br />$ 34,787.00 <br />($ ) <br />Previous Amount $ 1,348,000.00 <br />Current Percent of Change: <br />Increase <br />Decrease <br />2.58% <br />( %) <br /> New Amount $ 1,382,787.00 <br />Total Percent of Change: <br />Increase <br />Decrease <br />2.58% <br />( %) <br /> Time Extension Amount: 37 days <br />New Completion Date: 6/21/2023