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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 5/30/2025 <br />Name Dan Jones Department DPW <br />BPW Date 6/10/2025 Phone Extension 9245 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance ❑ Officer Name Michael Szymanski <br />and Inclusion Officer <br />BPW Attorney ❑ Attorney Name Michael Schmidt <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ❑ Mickey Lovey <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 N 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 />n Other: n 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 />Purpose/Description <br />Information <br />Milestone Contractors, L.P. <br />U Yes U If Yes, Approved by Purchasing <br />N No <br />❑❑ MBE Completed E-Verify Form Attached ❑ Yes <br />No <br />2025 Community Crossings <br />125-004; PROJ 617 <br />265-436008 <br />PR-40469 <br />13&000.00 <br />Award Divisions 1 & 2, plus Alternates 1 & 2 for the 2025 CCMG project. <br />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 />