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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 09/02/2025 <br />Name Zach Hurst Department DPW <br />BPW Date 09/09/2025 Phone Extension 3057 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance ❑ <br />Officer Name <br />and Inclusion Officer <br />BPW Attorney <br />❑ Attorney Name <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. I ❑ Traffic Control ❑ Resolution <br />n Other: n Ease./Encroach <br />Information <br />Company or Vendor Name <br />D-8 Glass <br />❑ Yes❑ If Yes, Approved by Purchasing <br />New Vendor <br />® No <br />❑❑ MBYes <br />MBE/WBE Contractor <br />E Completed E-Verify Form Attached ❑ <br />No <br />Project Name <br />Ivy Alley Windows — 321 W. Wayne St. <br />Project Number <br />125-029R <br />Funding Source <br />River West DA TIF <br />Account No. <br />PO-0038166 <br />Amount <br />This change: $5,346.80; Revised Amount: $70,000 <br />Terms of Contract <br />Purpose/Description <br />Change order number 1 uses the remaining TIF allotment to install an <br />additional window. <br />For Change Orders Only <br />Amount of ® Increase $ 5,346.80 <br />❑ Decrease ($ ) <br />Previous Amount $ 64,653.20 <br />Increase <br />Current Percent of Change: <br />Decrease <br />New Amount <br />$ 70,000 <br />Increase <br />Total Percent of Change: <br />Decrease <br />Time Extension Amount: <br />31 days <br />New Completion Date: <br />09/15/2025 <br />8.3% <br />8.3% <br />