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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 7-31-2023 <br />Name Coby Deal/ Sean Ward Department Streets <br />BPW Date Phone Extension 6001 <br /> <br />Review and Approval Required Prior to Submittal to Board Diversity Compliance <br />and Inclusion Officer Officer Name BPW Attorney Attorney Name <br />Dept. Attorney x Attorney Name Michael Schimdt <br /> <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 x 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 Avanti Flooring LLC <br />New Vendor Yes If Yes, Approved by Purchasing <br />X No <br />MBE/WBE Contractor MBE <br /> WBE Completed E-Verify Form Attached Yes <br /> No <br />Project Name Office Flooring Replacement <br />Project Number <br />Funding Source 202/ 641 50/50 split <br />Account No. 202-06-602-503-422000 / 641-06-602-509-42200 <br />Amount 9,945.94 <br />Terms of Contract <br />Purpose/Description To remove and replace all front admin office Carpet that is worn and stained <br />with new carpet and cove base for the entire Public Works Building at 731 S. <br />Lafayette Blvd. <br />_______________________________________________________________ <br />_______________________________________________________________ <br />______________________________________________ <br />For Change Orders Only <br />Amount of <br /> <br />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: