Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 8/5/2025 <br />Name Dan Jones Department DPW <br />BPW Date 8/12/2025 Phone Extension 9245 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance <br />and Inclusion Officer ❑ Officer Name <br />BPW Attorney ❑ Attorney Name <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ❑ <br />Check the Appropriate Item Type — <br />Professional Services Agreement ❑ Contract <br />❑ Open Market Contract <br />❑ Bid Opening <br />❑ Quote Opening <br />❑ Proposal Opening <br />❑ Chg. Order, No. <br />n Other: <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 />❑ Amendment/Addendum <br />❑ Bid Award <br />❑ Quote Award <br />❑ C/O & PCA No. <br />❑ Traffic Control <br />A&Z E <br />n Yes <br />Information <br />LLC <br />All Submissions <br />U Proposal <br />❑ Special Purchase, QPA <br />❑ Req. to Advertise <br />❑ Reject Bids/Quotes <br />❑ PCA <br />❑ Resolution <br />Ease./Encroach <br />If Yes, Approved by Purchasing <br />❑ Title Sheet <br />® No <br />❑ WBE Completed E-Verify Form Attached Yes <br />❑ No <br />Lathrop Street Water Main Loop <br />125-035 <br />251-431000 <br />PR-42543 <br />Amount $370,370.00 <br />Terms of Contract Hourly not -to -exceed, per task <br />Purpose/Description Services agreement to prepare design and bid package for water main loop <br />completion, roadway resurfacing, and sidewalk installation from Bendix Dr <br />to Portage Ave. <br />For Change Orders Only <br />Amount of ❑ Increase $ <br />❑ Decrease ($ ) <br />Previous Amount $ <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />Increase % <br />Decrease ( %) <br />Increase % <br />Decrease ( %) <br />New Completion Date: <br />