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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 4/2/2019 <br />Department <br />Name Sue Ellen Doudrick Eu inceri g Division <br />BPW Date 4/4/2019 Phone Extension 5922 <br />UNPIE � M <br />........._........--..___ ....... <br />Recpttird Prior to Submittal to Board <br />BPW Attorney E] Attorney Name <br />Dept. Attorney Attorney Name <br />Purchasing <br />Check the Appropriate Item Type <br />❑! Professional Services Agreement EJ Contract <br />Open Market Contract <br />Amendment/Addendum <br />[❑ <br />Bid Opening <br />❑ <br />Bid Award <br />E] Quote Opening <br />® Quote Award <br />EJ <br />Proposal Opening <br />❑ C/O & PCA No. <br />0 <br />Chg. Order, No. <br />❑ Traffic Control <br />El Other: <br />Required Information <br />All Submissions <br />L Proposal <br />❑ Special Purchase, QPA <br />Req. to Advertise <br />0 Reject Bids/Quotes <br />E] PCA <br />Resolution <br />Ease./Encroach <br />❑ Title Sheet <br />Company or Vendor Name <br />Sclg� Construction <br />If Yes Approved b Purchasing <br />� � � pp y urchasing <br />ng <br />New Vendor <br />No <br />MBE/WBE Contractor <br />MBE Completed E-Verify Form Attached El Yes <br />❑ No <br />Project Name <br />2019 Small Drainage (Lathrop) w <br />Project Number <br />119-019A <br />Funding Source <br />...,,,,.�.. ... ....... ...... .... ... <br />Storm Sewer Fund <br />Account No. <br />Fund 667 <br />Amount <br />667-0621.-792.42-04 Capital <br />Terms of Contract <br />Unit Prices <br />Purpose/Description Small Drainage repair on the south side of Lathrop between Riverside Drive & Parkviev <br />Place. Work is within ROW and includes removal of dumped materials, debris, and rubble <br />embankment stabilization, swale construction, inlet and manhole construction. To assist is <br />costs, Sewer Dept is supplying the hauling of excavated materials and manholes to reduc( <br />cost of project; Streets Dept is performing pavement patching. Other depts have also bees <br />involved in the !.I( t <br />.....�._._._..._....... For Change Orders Only <br />Amount of Increase $ <br />❑ Decrease ($ <br />Previous Amount <br />$ <br />.....Increase ............................�. <br />Current Percent of Change: <br />Decrease <br />New Amount <br />$ - <br />_,.. <br />crease <br />Increase <br />�_..........- ....—... <br />% <br />�. <br />Total Percent of Change: <br />Decrease <br />% <br />Time Extension Amount: <br />.���._.. <br />New Completion Date: <br />