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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 09/04/2019 <br />Name I o Villa Department: Engineering <br />BPW Date 09/24/2019 Phone Extension 5920 <br />vivimimuwmu�wiw� �u®ir�nmram�v wi�w�mir�mnn�!�n!r�m� <br />..._..... �..�.. <br />Required Prior to Submittal to Board <br />BPW Attorney Attorney Name <br />Dept. Attorney Attorney Name <br />Purchasing El <br />Check the ;Atn)1`0' 7riate Item Tvpe -- <br />❑ Professional Services Agreement ❑ Contract <br />Open Market Contract ❑ Amendment/Addendum <br />E] <br />Bid Opening ❑ Bid Award <br />[] <br />Quote Opening E Quote Award <br />❑ <br />Proposal Opening [:1 C/O & PCA No, <br />F <br />Chg. Order, No. Traffic Control <br />Other: <br />Information <br />Company or Vendor Name Bokon Masonry, Inc. <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 />Purpose/Description <br />All Submissions <br />L j Proposal <br />❑ Special Purchase, QPA <br />F-1 Req. to Advertise ❑ Title Sheet <br />❑ Reject Bids/Quotes <br />® PCA <br />Resolution <br />Ease./Encroach <br />U Yes U If Yes, Approved by Purchasing <br />® No <br />❑ WBE Completed E-Verify Form Attached ❑❑ Nos <br />Gemini Wit hinjon-wColfax Masonry and Stair Repairs <br />118-080B <br />West asliitj ton 1 Ifw �.._ ....._.. ,. <br />422-1050-460-42.02 <br />$237,713.00 <br />Protect Closeout <br />For Chic mOrders Only wmw <br />Amount of Increase $ <br />❑ Decrease ($ <br />Previous Amount <br />$ <br />Increase <br />% <br />Current Percent of Change: <br />Decrease <br />( % <br />New Amount <br />$ <br />Increase <br />Total Percent of Change: <br />Decrease <br />% <br />Time Extension Amount: <br />New Completion Date: <br />