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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 07-01-2024 <br />Name: Jacob M. Klosinski Department of Public Works – Engineering Division <br />BPW Date: 07-09-2024 Phone Extension: 9496 <br /> <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Michael Schmidt <br />Dept. Attorney Attorney Name Michael Schmidt <br /> <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 Sewer Repair – Bendix and Westmoor Intersection <br />Project Number 124-045 <br />Funding Source Sewer Operations, Other Contractual Service <br />Account No. PR-00034555; Acct. No. 641-06-602-509-439001 <br />Amount <br />Terms of Contract Lump Sum and Unit Prices <br />Special Contract Provisions Work to be completed by August 10, 2024 <br />Purpose/Description The Division of Engineering and Sewer Department request the Board of <br />Public Works open quotations at its meeting on July 9, 2024. The Division of <br />Engineering would like to review quotations received at the meeting and <br />provide an award recommendation at the July 9, 2024, Board meeting to <br />expedite repair work and coordinate materials procurement. <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 /> <br />New Amount $ <br />Total Percent of Change: <br />Increase <br />Decrease <br />% <br />(%) <br /> <br />Time Extension Amount: <br />New Completion Date: <br />