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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 07/14/2023 <br />Name Becca Plantz Department Public Works <br />BPW Date 07/25/2023 Phone Extension 5998 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance <br />and Inclusion Officer ❑ Officer Name Cynthia Simmons <br />BPW Attorney <br />❑ Attorney Name <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ❑ <br />Michael Scmidt <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. 2 ❑ PCA <br />❑ Chg. Order, No. 2 ❑ Traffic Control ❑ Resolution <br />n Other: n Ease./Encroach <br />Information <br />Company or Vendor Name Viking Painting, LLC <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 />Amount of ❑ <br />Previous Amount <br />U YesU If Yes, Approved by Purchasing <br />❑ No <br />❑❑ WBE Completed E-Verify Form Attached ❑ Nos <br />Northwest Elevated Tank Improvements <br />122-018 <br />Water Works Capital — Distribution /Reservoirs <br />PROJ 319 <br />$1,228,400.00 <br />Lump Sum <br />Change order 2 to deduct the contract in the amount of remaining punch list <br />items and project closeout. <br />For Change Orders Only — <br />Increase $ <br />Decrease <br />$1 <br />($ 35,500.00) <br />055.00 <br />Increase % <br />Current Percent of Change: Decrease (2.89%) <br />New Amount $ 1,185,155.00 <br />Increase % <br />Total Percent of Change: Decrease (3.52%) <br />Time Extension Amount: <br />New Completion Date: <br />