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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 09/07/2023 <br />Name Patrick Sherman Department Public Works <br />BPW Date 09/12/2023 Phone Extension 5601 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance ❑ <br />Officer Name <br />and Inclusion Officer <br />BPW Attorney <br />® Attorney Name <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ® Mickey Lovy <br />Check the Appropriate Item I <br />Professional Services Agreement ❑ Contract <br />❑ Open Market Contract <br />❑ Bid Opening <br />❑ Quote Opening <br />❑ Proposal Opening <br />❑ Chg. Order, No. <br />I-1 Other: <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 />Michael Schmidt <br />❑ Amendment/Addendum <br />❑ Bid Award <br />® Quote Award <br />❑ C/O & PCA No. <br />❑ Traffic Control <br />Information <br />A 1 Concrete <br />All Submissions <br />U Proposal <br />❑ Special Purchase, QPA <br />❑ Req. to Advertise <br />❑ Reject Bids/Quotes <br />❑ PCA <br />❑ Resolution <br />Ease./Encroach <br />❑ Title Sheet <br />U Yes U If Yes, Approved by Purchasing <br />® No <br />❑ MBE Completed E-Verify Form Attached ❑ Yes <br />No <br />Boehm Park Pavilion Post Footings <br />PROJ00000414 <br />PR-00027527 <br />201-11-206-273-445003--PROJ00000414 <br />Amount $9 <br />Terms of Contract Lump sum: simple quote <br />Purpose/Description Footings for new pavilion at Boehm Park. Was originally going to be done by <br />in-house labor but there was some employee turnover. The actual pavilion wil <br />still be installed by City's own workforce. <br />For Change Orders Only <br />Amount of ❑ Increase $ <br />❑ Decrease ($ ) <br />Previous Amount $ <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />Increase <br />Decrease <br />Increase <br />Decrease <br />New Completion Date: <br />