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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 12/27/2022 <br />Name: Kelly Smith Department of Public Works <br />BPW Date: 02/28/2023 Phone Extension:5795 <br />Required Prior to Submittal to Board <br />BPW Attorney X Michael Schmidt <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ® Mickey Lovy <br />Check the Appropriate Item Type — Re uired or 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 />Company or Vendor Name <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 />Information <br />Otto Environmental Svstems <br />❑ Yes[:] If Yes, Approved by Purchasing <br />® No <br />❑ WBE Completed E-Verify Form Attached ❑❑ Neos <br />Bid for Six Thousand (6,000) More or Less Universal/Nestable Refuse and Yard <br />Waste Containers <br />610-06-603-512-422000 <br />PR #00021076 <br />Unit Prices — 24 month contract <br />Purchase of Six Thousand (6,000) More or Less Universal/Nestable Refuse and <br />Yard Waste Containers — 24- month contract. <br />For Change Orders Only <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 />New Completion Date: <br />Increase <br />Decrease <br />Increase <br />Decrease <br />