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Dedicated Improvements Agreement - Temp. Asphalt Drive – Beacon Health System Memorial Hospital
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Dedicated Improvements Agreement - Temp. Asphalt Drive – Beacon Health System Memorial Hospital
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1/9/2024 11:02:50 AM
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1/9/2024 11:02:32 AM
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Board of Public Works
Document Type
Contracts
Document Date
1/9/2024
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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 12/19/2023 <br />Name: Gemma Stanton Department of Public Works – Engineering Division <br />BPW Date: 1/9/2024 Phone Extension: 9083 <br /> <br />Required Prior to Submittal to Board BPW Attorney X Attorney Name Michael Schmidt <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. Traffic Control Resolution <br /> Other: Dedicated <br />Improvements Agreement <br /> Ease./Encroach <br />Required Information <br />Company or Vendor Name Beacon Medical Group <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 N/A <br />Project Number N/A <br />Funding Source N/A <br />Account No. N/A <br />Amount N/A <br />Terms of Contract <br />Purpose/Description Dedicated improvements agreement to allow Beacon to install temporary <br />asphalt drive approaches for Beacon Tower construction. Sidewalk, curb, and <br />landscaping shall be replaced when the project is finished. <br />For Change Orders Only <br />Amount of <br /> <br />Increase <br />Decrease <br />$ <br />($ ) <br />Previous Amount $ <br />Current Percent of Change: <br />Increase <br />Decrease <br /> % <br />( %) <br /> New Amount $ <br />Total Percent of Change: <br />Increase <br />Decrease <br /> % <br />( %) <br /> Time Extension Amount: <br />New Completion Date: <br />
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