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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 3/18/2025 <br />Name: Sarah Barber Department: Public Works <br />BPW Date: 3/20/2025 Phone Extension: 9805 <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Michael Schmidt <br />Dept. Attorney ❑ Attorney Name Michael Schmidt <br />Purchasing ❑ <br />Mickey Lovy <br />Check the Appropriate <br />Item Type — Re uired or All Submissions <br />❑ Professional Services Agreement <br />❑ 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 />_Preliminary Engineering <br />Report Acceptance Resolution <br />and Signatory Authorization <br />Reauired Information <br />Company or Vendor Name <br />New Vendor ❑ Yes ❑ If Yes, Approved by Purchasing <br />❑ No <br />MBE/WBE Contractor ❑ WBE Completed E-Verify Form Attached ❑❑ Nos <br />2025 Preliminary Engineering Report for State Revolving Funds North <br />Water Treatment Plant PFAS Minimization, Edison Water Filtration Plant, <br />Project Name and Lead Service Line Replacement <br />Project Number 124-056 <br />Funding Source <br />Account No. PR/PO # N/A <br />Amount <br />Terms of Contract <br />Special Contract Provisions <br />Purpose/Description <br />For Change Orders Only <br />N/A <br />