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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 8/14/23 <br />Name: Gemma Stanton Department of Public Works — Engineering Division <br />BPW Date: 8/22/2023 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 — 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 <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 />Reauired Information <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 />Purpose/Description <br />Premium Concrete <br />❑ Title Sheet <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 / Major Moves <br />202-06-602-505-431000 / 412-06-600-506-431000 <br />Division A - $64,949; Division B - $335,583; Division C — $246,378; <br />Division D - $157,478; Division E - $169,030 <br />Award bid for 2023 Curb and Sidewalk work related to Council Allocation <br />program. Award all 5 divisions to lowest bidder Premium Concrete. Note: <br />separate financial requisitions for each division to create separate Purchase <br />Orders for each. <br />snoopy— 4� For Change Orders Onl <br />Amount of ❑ Increase $ <br />❑ Decrease ($ ) <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Increase % <br />Decrease <br />Increase % <br />Total Percent of Change: Decrease <br />Time Extension Amount: <br />New Completion Date: <br />