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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 01 /31 /2023 <br />Name Becca Plantz Department Public Works <br />BPW Date 02/14/2023 Phone Extension 5998 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance <br />and Inclusion Officer ❑ Officer Name <br />BPW Attorney <br />❑ Attorney Name <br />Dept. Attorney ❑ Attorney Name <br />Michael Schmidt <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 <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 />Reauired Information <br />Company or Vendor Name Acculevel Commercial Group, Inc. <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />YesU If Yes, Approved by Purchasing <br />❑ Title Sheet <br />❑ No <br />❑ WBE Completed E-Verify Form Attached ❑❑ Nos <br />Walker Field House Restoration Project <br />120-01 OR <br />EDIT and NPS Grant <br />PROJ-212, PR-14932 <br />Total $74,040.00 (Base: $28,764, Alternate 1: $45,276) <br />Lump Sum <br />Requote of structural improvements to the Walker Field Park Shelterhouse <br />with scope focused on helical piers. <br />For Change Orders Onl <br />Amount of ❑ Increase $ <br />❑ Decrease ($ ) <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />Increase <br />Decrease <br />Increase <br />Decrease <br />New Completion Date: <br />