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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 11 / 13/2019 <br />Name Tov Villa <br />Department: Engineering <br />BPW Date 11/26/2019 Phone Extension 5920 <br />Required Prior to Submittal to Board <br />._.__ <br />BPW Attorney ❑ Attorney Name <br />Dept. Attorney ❑ Attorney Name <br />Purchasing [l <br />Check the A ro riate Ite�e — Require <br />Professional Services Agreement Contract <br />Ej Open Market Contract ❑ Amendment/Addendum <br />❑ Bid Opening F� Bid Award <br />❑ Quote Opening ❑ Quote Award <br />Proposal Opening Z C/O & PCA No.l Final <br />E] Chg. Order, No. ❑ Traffic Control <br />F-1 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 />{or All Submissions <br />Proposal <br />Special Purchase, QPA <br />❑ Req. to Advertise ❑ Title Sheet <br />Reject Bids/Quotes <br />E] PCA <br />Resolution <br />O.Eae./Encroach <br />vvv <br />Acorn Landscaping LLC <br />YcsEJ If Yes, Approved by Purchasing <br />No <br />MBE Completed E-Verify Form Attached El Yes <br />WBE No <br />2018 Downspoutnrogram Disconnect P.._ ............... <br />118-014 <br />..— .................... .......... _. <br />Wastewater O & M <br />................—....._..................... ........... <br />641.0630.793.6335 <br />For Claa�a e Orders 0��1 <br />Amount of ❑ Increase $ <br />® Decrease ($ 17,015 10) <br />Previous Amount $ 47,813.75 <br />..... _ ........... ............. ..-.. ........... .______..........— <br />Increase % <br />Current Percent of Change: Decrease (35 59%) <br />_.. ................. <br />New Amount $ 30,798.65 <br />..... <br />............... ..._------- ------- <br />Increase % <br />Total Percent of Change: Decrease (35.590/) <br />Time Extension Amount: <br />— ................. ............... ... <br />New Completion Date: <br />