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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 7/31/2023 <br />Name: Charlie Brach Department of Public Works – Engineering Division <br />BPW Date: 8/22/2023 Phone Extension: 9246 <br /> <br />Required Prior to Submittal to Board BPW Attorney X Attorney Name <br />Dept. Attorney Attorney Name <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 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 Selge Construction Co. <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 122-014C 2023 Traffic Calming <br />Project Number PROJ316 <br />Funding Source 251-442001 <br />Account No. <br />PO # 23430 (Division 1), PO # 23429 (Division 2), PO # 23419 (Division <br />3), PO # 23411 (Division 4), PO # 23428 (Division 5), PO # 23427 <br />(Division 6) <br />Amount $59,656.85 <br />Terms of Contract Divisions <br />Special Contract Provisions N/A <br />Purpose/Description Change Order for the 2023 Traffic Calming Project to add curb, #53 <br />Aggregate and Thermoplastic Striping. <br />For Change Orders Only <br />Amount of <br /> <br />Increase <br />Decrease <br />$ 59,656.85 <br />($ ) <br />Previous Amount $ 1,750,570.00 <br />Current Percent of Change: <br />Increase <br />Decrease <br />3.41% <br />( %) <br /> <br />New Amount $ 1,810,226.85 <br />Total Percent of Change: <br />Increase <br />Decrease <br />3.41% <br />( %) <br /> <br />Time Extension Amount: <br />New Completion Date: