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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 1 /7/2025 <br />Name: Jake Koestner Department of Public Works — Engineering Division <br />BPW Date: 1/14/2025 Phone Extension: 7483 <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name <br />Dept. Attorney ❑ Attorney Name <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: ❑ Ease./Encroach <br />Information <br />Company or Vendor Name <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />New Vendor <br />❑ No <br />MBE <br />MBE/WBE Contractor <br />Completed E-Verify Form Attached ❑ Nos <br />❑ <br />Project Name <br />WWTP Aeration Area Lighting <br />Project Number <br />124-067 <br />Funding Source <br />Account No. <br />PR-00038419 <br />Amount <br />Approximately $16,000 <br />Terms of Contract <br />Special Contract Provisions <br />Purpose/Description <br />This project consists of the procurement and installation of five (5) new <br />1000W-equivalent lights mounted on 20' riser poles and buried in concrete <br />foundations along the eastern edge of the aeration basins at the wastewater <br />treatment plant. <br />For Change Orders Only <br />Amount of ❑ <br />Increase $ <br />❑ <br />Decrease ($ ) <br />Previous Amount <br />$ <br />Increase % <br />Current Percent of Change: <br />Decrease ( %) <br />New Amount <br />$ <br />Increase % <br />Total Percent of Change: <br />Decrease ( %) <br />Time Extension Amount: <br />New Completion Date: <br />