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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: May 1, 2023 <br />Name: Daniel Sexton <br />Department of Public Works — Engineering Division <br />BPW Date: May 9, 2023 Phone Extension: 5903 <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Micheal Schmidt <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ❑ <br />I Check the ADDropriate Item Tvne — Reauired for All Submissions I <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 />❑ Yes❑ If Yes, Approved by Purchasing <br />❑ No <br />MBE ❑ WBE Completed E-Verify Form Attached ❑ Nos <br />2023 Tree and Stump Removal <br />123-002 <br />PR-00024705 — Motor Vehicle Highway <br />202-06-602-505-431000 <br />Contractor quote for 2023 Tree and Stump Removal to facilitate internal <br />Curb and Sidewalk work. <br />For Change Orders Only <br />Amount of ❑ Increase $ <br />❑ Decrease ($ ) <br />Previous Amount <br />Increase <br />Current Percent of Change: Decrease <br />New Amount $ <br />Increase <br />Total Percent of Change: Decrease <br />Time Extension Amount: <br />New Completion Date: <br />