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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 5/3/2023 <br />Name: Daniel Sexton Department of Public Works – Engineering Division <br />BPW Date: 5/23/2023 Phone Extension: 5903 <br />Required Prior to Submittal to Board <br />BPW Attorney X 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 Premium Concrete Services Inc <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 2022 Curb and Sidewalk Round 1 (Division 3, 4, & 5) <br />Project Number 122-001 <br />Funding Source <br />PR-00016964 (2022 Curb/SW Program: ARP Neighborhood <br />Infrastructure) <br />Account No. 202-06-602-505-431000--PROJ00000334 <br />Amount $393,685.00 <br />Terms of Contract NTE <br />Special Contract Provisions n/a <br />Purpose/Description Change order to increase project amount to $393,685.00. There were changes <br />in project scope during construction resulting in over-runs. <br />For Change Orders Only <br />Amount of Increase <br />Decrease <br />$9,852.98 <br />($ ) <br />Previous Amount $ 393,685.00 <br />Current Percent of Change: <br />Increase <br />Decrease <br />2.5% <br />(%) <br />New Amount $403,537.98 <br />Total Percent of Change: <br />Increase <br />Decrease <br />2.5% <br />(%) <br /> Time Extension Amount: 21 days <br />New Completion Date: 11/18/2022 <br /> X