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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date October, 15, 2019 <br />Department <br />Name Jacob M. Klosinski Engineerin / Utilities <br />BPW Date October 22,,2019 Phone Extension Ext. 9496 <br />Re uirtl Prior to Submittal to Board <br />BPW Attorney ® Attorney Name Clara McDaniels <br />Dept. Attorney n Attorney Name <br />Purchasing ❑ <br />Check the A ppropriate Item Type —Re Re i r Sri° A11 Submissions <br />Professional Services Agreement Contract Proposal <br />El Open Market Contract ❑ Amendment/Addendum 0 Special Purchase, QPA <br />[:1 Bid Opening ❑] Bid Award ® Re to Advertise <br />Quote Opening Quote Award q� ®Title Sheet <br />Q p g ❑ Q ❑ Reject Bids/Quotes <br />Proposal Opening C/O & PCA No. PCA <br />E] <br />Chg. Order, No. Traffic Control ❑ Resolution <br />EI <br />Other: Ease./Encroach <br />Ret tdred Information <br />Company or Vendor Name <br />New Vendor <br />❑ YesD If Yes, Approved by Purchasing <br />❑] No <br />MBE/WBE Contractor <br />MBE ❑ WBE Completed E-Verify Form Attached ❑ Nos <br />Project Name <br />WWTP SeconLaly and Disinfection Im rovements <br />Project Number <br />119-069 <br />Funding Source <br />Sewage Works Capital <br />642-0621-415-42-05 (Sewer Rehab.); 642-0630-415-43-66 (Treatment & <br />Account No. <br />Disposal Ecquipment)m <br />Amount- <br />- <br />Terms of Contract <br />Purpose/Description <br />The Division of I nt7ineerin and Division of l Ptilities rag oast the Boaagl of <br />Public Works awroval of the Title Sheet', and Reg uest tQ Advertise for ProLect. <br />No. 119-069 WWTP Secondae Treattrwent In coven ants �e Cit <br />continued efforts to it Wastewater Treatment Plant for con )fiance <br />nILIVUHL %J1 EJ Decrease ($ ) <br />wW <br />Previous Amount $ <br />Increase % <br />Current Percent of Change: Decrease <br />New Amount $ <br />Increase % <br />Total Percent of Change: Decrease %o) <br />Time Extension Amount: <br />New Completion Date: <br />