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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: June 20, 2023 <br />Name: Sarah Barber Department of Public Works – Engineering Division <br />BPW Date: June 27, 2023 Phone Extension: 9805 <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Michael Schmidt <br />Dept. Attorney Attorney Name 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 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 A&Z Engineering, LLC <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 Watermain Replacements at Greenlawn Ave. & S. 30th St. <br />Project Number ENG: 122-041 <br />Funding Source 622-06-604-442007 <br />Account No. PR-00017286 <br />Amount $17,860 <br />Terms of Contract <br />Special Contract Provisions <br />Purpose/Description The Division of Engineering requests the Board of Public Works approve <br />Admendment 1 for additional design and field services required by the <br />railroad authority for the subject watermain replacements at Greenlawn Ave. <br />and S. 30th St. at its 6/27/2022 regular meeting <br />For Change Orders Only <br />Amount of In crease <br />Decrease <br />$ <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: