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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date November w 2019 <br />Name Kyle Silveus Department Engineering <br />BPW Date November 12 2019 Phone Extension 9083 <br />Required Prior to Submittal to Board <br />BPW Attorney Attorney Name — <br />Dept. Attorney F-I Attorney Name <br />Purchasing <br />Check the Appropriate Item Type <br />Professional Services Agreement F-1 Contract <br />Open Market Contract <br />n <br />Amendment/Addendum <br />Bid Opening <br />Z <br />Bid Award <br />❑ Quote Opening <br />F] <br />Quote Award <br />❑ <br />Proposal Opening <br />[:] <br />C/O & PCA No. <br />Chg. Order, No. <br />E] <br />Traffic Control <br />EJ Other: <br />Company or Vendor Name <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 />Information <br />All Submissions <br />LJ Proposal <br />[l Special Purchase, QPA <br />E] Req. to Advertise <br />F1 Reject Bids/Quotes <br />❑ PCA <br />Resolution <br />Ease./Encroach <br />❑ Title Sheet <br />Division A — Ritschard Bros, Inc.; Division B — Green Demolition <br />Contractors <br />..... .................. ... .... ..._____- <br />Yes If Yes, Approved by Purchasing <br />No <br />MBE Completed E-Verify Form Attached Yes <br />❑ WBE No <br />2019 Demolitions, Phase 2 <br />119-079 <br />Vacant & Abandon <br />404.1201.415.39.87 <br />Division A - $125,825; Division B - $122,565 <br />Base Bid <br />For Change Orders Only <br />Amount of EJ Increase $ .......... <br />......... <br />... <br />_ .... <br />El Decrease <br />..................................................................... ... .... <br />__._ <br />Previous Amount <br />$ ...................... __.. <br />Increase <br />% <br />Current Percent of Change: <br />Decrease <br />% <br />New Amount <br />$ <br />Increase <br />% <br />Total Percent of Change: <br />Decrease <br />% <br />Time Extension Amount: <br />New Completion Date: <br />