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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 8/14/2025 <br />Name: Rebecca Maenhout Department of Public Works — Engineering Division <br />BPW Date: 8/26/2025 Phone Extension: 5996 <br />Required Prior to Submittal to Board <br />BPW Attorney X 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 ❑ 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. 1 ❑ 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 />Special Contract Provisions <br />Purpose/Description <br />Information <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />❑ No <br />E] MBE ❑ WBE Completed E-Verify Form Attached El Yes <br />❑ No <br />Studebaker Golf Roof Repair <br />N/A <br />201-11-201-201-436000-- <br />PR/PO # PO-0039125 <br />After uncovering the roof, there was damage to the wood and insulation. <br />Roughly 500 sgft needs remediation. <br />For Change Orders Only <br />Amount of ® Increase $ 5,800.00 <br />❑ Decrease ($ ) <br />Previous Amount $ 23,339.13 <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />New Completion Date: <br />Increase 19.9% <br />Decrease ( %) <br />$ 29,139.13 <br />Increase 19.9% <br />Decrease ( %) <br />