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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 02/29/2024 <br />Name Kvle Ludlow Department Public Works <br />BPW Date 03/12/2024 Phone Extension 9157 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance ❑ <br />Officer Name <br />and Inclusion Officer <br />BPW Attorney ❑ Attorney Name <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ❑ <br />Check the Appropriate Item Type — Re uired or 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. 1 ❑ PCA <br />❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution <br />n Other: n Ease. /Encroach <br />Information <br />Company or Vendor Name Traffic Control Specialists, LLC <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 />U Yes U If Yes, Approved by Purchasing <br />® No <br />MBE ❑ WBE Completed E-Verify Form Attached ❑❑ Nos <br />Multi -Component Striping <br />122-065 <br />PR-00021150 <br />PR-00000402 PO-0020953 <br />$16,580.77 <br />Purpose/Description _Project Closeout and Final Change Order <br />For Change Orders Only <br />Amount of ❑ Increase $ <br />® Decrease ($ 1,258.17) <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 />$ 17,838.94 <br />Increase % <br />Decrease <br />$ 16,580.77 <br />Increase <br />Decrease <br />0 days <br />5/ 17/2023 <br />-7.05% <br />-7.05% <br />