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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 01-16-2024 <br />Name: Jacob M. Klosinski Department of Public Works – Engineering Division <br />BPW Date: 01-23-2024 Phone Extension: 9496 <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Michael Schmidt <br />Dept. Attorney Attorney Name Michael Schmidt <br />Purchasing Mickey Lovy / Ron O'Connor <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: Ease./Encroach <br />Required Information <br />Company or Vendor Name <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 WWTP Degrit Building Yard Piping Replacement <br />Project Number 123-031A / PROJ00000435 <br />Funding Source Sewage Works – Wastewater Capital <br />Account No. PR/PO # <br />Amount <br />Terms of Contract <br />Special Contract Provisions <br />Purpose/Description The Division of Engineering and Division of Wastewater request approval of <br />a Title Sheet and Request to Advertise for Public Bids for the subject project. <br />Bids will be due to the Board of Public Works on February 27, 2024. Refer to <br />Inter-Office Memorandum for additional information. <br />For Change Orders Only <br />Amount of Increase <br />Decrease <br />$ <br />($ ) <br />Previous Amount $ <br />Current Percent of Change: <br />Increase <br />Decrease <br />% <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 />January 23, 2024