Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 6/30/2025 <br />Name: Gemma Stanton Department of Public Works — Engineering Division <br />BPW Date: 7/8/2025 Phone Extension: 9246 <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Michael Schmidt <br />Dept. Attorney ❑ Attorney Name <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: Utility Extension ❑ Ease./Encroach <br />Information <br />Company or Vendor Name <br />S&J Real Estate Holdings LLC <br />❑ Yes❑ If Yes, Approved by Purchasing <br />New Vendor <br />❑ No <br />MB❑ <br />MBE/WBE Contractor <br />❑ E Completed E-Verify Form Attached ❑ Nos <br />Project Name <br />2240 Prairie <br />Project Number <br />DP22-018 <br />Funding Source <br />N/A <br />Account No. <br />PRAP04 N/A <br />Amount <br />N/A <br />Terms of Contract <br />N/A <br />Special Contract Provisions <br />N/A <br />Purpose/Description <br />Water Extension Acceptance for 2240 Prairie <br />For Change Orders Only <br />Amount of ❑ <br />Increase $ <br />❑ <br />Decrease ($ ) <br />Previous Amount <br />$ <br />Increase % <br />Current Percent of Change: <br />Decrease ( %) <br />New Amount <br />$ <br />Increase % <br />Total Percent of Change: <br />Decrease ( %) <br />Time Extension Amount: <br />New Completion Date: <br />