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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 03/07/2023 <br />Name Patrick Sherman Department Public Works <br />BPW Date 03/14/2023 Phone Extension 5601 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance <br />and Inclusion Officer Officer Name <br />BPW Attorney Attorney Name Michael Schmidt <br />Dept. Attorney Attorney Name <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: Ease./Encroach <br />Required Information <br />Company or Vendor Name TBD <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 2023 VPA Athletic Court Renovations <br />Project Number PROJ00000414 – 123-040 <br />Funding Source Fund 201: PR-00023268 <br />Account No. 201-11-206-273-445003-- <br />Amount TBD <br />Terms of Contract BID <br />Purpose/Description __Phase 3 of renovations of asphalt athletic courts in multiple <br />parks.__________________________________________________________ <br />________________________________ <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 />March 14, 2023