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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 9/29/2023 <br />Name Scott Kree er <br />BPW Date 10/10/2023 <br />BPW Attorney <br />Dept. Attorney □ <br />Purchasing <br />Department Public <br />Works <br />Phone Extension <br />Required Prior to Submittal to Board <br />Attorney Name Michael Schmidt <br />Attorney Name <br />Mickey Loyy <br />9245 <br />I Check the Appropriate Item Type -Required for All Submissions <br />D Professional Services Agreement D Contract D Proposal <br />D Open Market Contract D Amendment/Addendum D Special Purchase, QPA D Bid Opening D Bid Award D Req. to Advertise D Title Sheet D Quote Opening D Quote Award D Reject Bids/Quotes 0 Proposal Opening O C/0 & PCA No.__ 0 PCA [gl Chg. Order, No.! D Traffic Control D Resolution <br />D Other: D Ease./Encroach I Required 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 />Acorn Landscaping, LLC <br />D YesD If Yes, Approved by Purchasing <br />[gi No B �:� Completed E-Verify Form Attached <br />2023 Brick Spot Repair <br />123-057 (PR-25460) <br />Economic Development <br />408-06-602-503-436008 <br />2023 Brick Spot Repair <br />OYes □No <br />Terms of Contract <br />Purpose/Description Change Order# I -Additional work to remove and replace discovered clay <br />drain pipe at LaSalle & Scott. <br />Amount of <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />New Completion Date: <br />For Change Orders Only <br />Increase $ I 0,948 --'----''-----------------------Decrease $ --'--'---'---------------------$ 169,850 <br />Increase 6.09% <br />Decrease ( % <br />$ 180,798 <br />Increase 6.09% <br />Decrease % <br />0