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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 12/31/2024 <br />Department Public <br />Name Lidva Abreha <br />BPW Date 01/14/2024 Phone Extension 5961 <br />Required Prior to Submittal to Board <br />BPW Attorney ® <br />Attorney Name Michael Schmidt <br />Dept. Attorney ❑ <br />Attorney Name <br />Purchasing ❑ <br />Mickey Lovy <br />Check the Appropriate <br />Item Type — Re uired or All Submissions <br />❑ Professional Services Agreement ❑ Contract <br />❑ Proposal <br />❑ Open Market Contract <br />❑ Amendment/Addendum <br />❑ Special Purchase, QPA <br />❑ Bid Opening <br />® Bid Award <br />❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening <br />❑ Quote Award <br />❑ Reject Bids/Quotes <br />❑ Proposal Opening <br />❑ C/O & PCA No. <br />❑ PCA <br />❑ Chg. Order, No. <br />❑ Traffic Control <br />❑ Resolution <br />❑ Other: <br />❑ Ease./Encroach <br />Reauired Information <br />Company or Vendor Name Slatile Roofing and Sheet Metal Co. <br />New Vendor ❑ Yes❑ If Yes, Approved by Purchasing <br />® No <br />MBE/WBE Contractor ❑ WBE Completed E-Verify Form Attached ❑❑ Nos <br />Project Name SBFD Central Fire Station Roofing Replacement (task 1) <br />Project Number R124-032A (PROJ00000507) <br />Funding Source Fire Departmental Capital (1) <br />Account No. 287-443001 <br />Amount $696,812.00 <br />Terms of Contract Lump Sum <br />Purpose/Description <br />For Change Orders Only <br />Amount of ❑ Increase $ <br />❑ Decrease ($ ) <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 />Increase <br />Decrease <br />Increase <br />Decrease <br />