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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 1 /7/2025 <br />Name Joseph Molnar Department DCI <br />BPW Date 1/14/25 Phone Extension 6022 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance ❑ <br />Officer Name <br />and Inclusion Officer <br />BPW Attorney <br />❑ Attorney Name <br />Dept. Attorney ® Attorney Name Danielle Campbell Weiss <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: Approval of Access ❑ Ease./Encroach <br />Agreement <br />Required Information <br />Company or Vendor Name <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 />Redevelopment Commission, Studebaker Admin QOZB <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />❑ No <br />E] MBE ❑ WBE Completed E-Verify Form Attached ❑❑ Nos <br />Environmental Abatement and Access Agreement <br />Purpose/Description The Redevelopment Commission and Studebaker Admin QOZB have come t( <br />an agreement on a renovation/stabilization plan of the former Studebaker <br />Admin Building. This agreement gives the BPW access to the building for the <br />abatement of environmental concerns within the building. <br />INN For Change Orders Only <br />Amount of ❑ Increase $ <br />❑ Decrease ($ ) <br />Previous Amount $ <br />Increase % <br />Current Percent of Change: Decrease ( %) <br />New Amount $ <br />Increase % <br />Total Percent of Change: Decrease ( %) <br />Time Extension Amount: <br />New Completion Date: <br />