HomeMy WebLinkAboutTitle Sheet - Eddy and Howard Street Sewer Relocation and Water Main Loop Proj No. DP 20-0202/19/20212/19/202102/19/20212/19/2021
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 12/19/20
Name Sue Ellen Doudrick Department DPW
BPW Date 2/23/21 Phone Extension 3057
Review and Approval Required Prior to Submittal to Board Diversity Compliance
and Inclusion Officer Officer Name BPW Attorney Attorney Name
Dept. Attorney Attorney Name
Purchasing
Check the Appropriate Item Type – Required for All Submissions
Professional Services Agreement Contract Proposal
Open Market Contract Amendment/Addendum Special Purchase, QPA
Bid Opening Bid Award Req. to Advertise Title Sheet
Quote Opening Quote Award Reject Bids/Quotes
Proposal Opening C/O & PCA No. PCA
Chg. Order, No. Traffic Control Resolution
Other: Ease./Encroach
Required Information
Company or Vendor Name
New Vendor Yes If Yes, Approved by Purchasing
No
MBE/WBE Contractor MBE
WBE Completed E-Verify Form Attached Yes
No
Project Name Eddy and Howard Street Sewer Relocation and Water Main Loop
Project Number DP 20-020
Funding Source n/a
Account No. n/a
Amount n/a
Terms of Contract n/a
Purpose/Description Eddy Street Phase III Grocery Store development requires the construction of
a water main loop and sanitary sewer relocation. The Utility Extension
Agreement is expected to be presented to the Board in an upcoming BPW
mtg. Grocery store requires water and sewer by May 1.
For Change Orders Only
Amount of
Increase
Decrease
$
($ )
Previous Amount $
Current Percent of Change:
Increase
Decrease
%
( %)
New Amount $
Total Percent of Change:
Increase
Decrease
%
( %)
Time Extension Amount:
New Completion Date: