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Date: <br />Name: <br />BPW Date: <br />5/13/2025 <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />5/5/2025 <br />Gemma Stanton Department of Public Works — Engineering Division <br />Phone Extension: 9083 <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name <br />Dept. Attorney ❑ Attorney Name <br />Purchasing <br />❑� <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 />F-1 Other: I —I Ease./Encroach <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 />Special Contract Provisions <br />Purpose/Description <br />Amount of ❑ <br />El <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />New Comnletion Date: <br />Information <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />❑ No <br />E] Yes <br />❑ WBE Completed E-Verify Form Attached ❑ No <br />Urban Half Moon Tree Nursery <br />n/a <br />USDA Urban & Community Forestry Grant - 212-10-101-132-439300 <br />PR#00040816 <br />Unit <br />Construction of Half Moon Tree Nursery at Ignition Park <br />Increase <br />Decrease <br />Increase <br />Decrease <br />Increase <br />Decrease <br />