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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 7/31 /23 <br />Name: Gemma Stanton Department of Public Works — Engineering Division <br />BPW Date: 8/8/23 Phone Extension: 9083 <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Michael Schmidt <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ❑ <br />Check the Appropriate Item Type — Re uired or 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 />n Other: n Ease./Encroach <br />Company or Vendor Name <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 />Information <br />U Yes❑ If Yes, Approved by Purchasing <br />❑ No <br />❑ WBE Completed E-Verify Form Attached ❑ Yes <br />No <br />2023 Curb & Sidewalk <br />123-001 <br />Motor Vehicle Highway <br />202-06-602-505-431000 <br />Purpose/Description Bid opening for 2023 Curb and Sidewalk work related to Council Allocation <br />program. To contain 5 divisions, divisible bid. Note: separate financial <br />requisitions for each division to create separate Purchase Orders for each. <br />For Change Orders Only <br />Amount of <br />❑ Increase $ <br />❑ Decrease ($ ) <br />Previous Amount <br />Increase <br />Current Percent of Change: Decrease <br />New Amount $ <br />Increase <br />Total Percent of Change: Decrease <br />Time Extension Amount: <br />New Completion Date: <br />