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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 10/01/2020 <br />Name Zach Hurst Department LUr• <br />BPW Date 10/13/2020 Phone Extension 3057 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance <br />and Inclusion Officer ❑ Officer Name <br />BPW Attorney ❑ Attorney Name <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ❑ <br />Check the Appropriate Item Type — Re uired or All Submissions <br />❑ Professional Services Agreement ❑ Contract ❑ Proposal <br />❑ Open Market Contract ❑ Amendment/Addendum ❑ Special Purchase, QPA <br />❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening ❑ Quote Award ❑ Reject Bids/Quotes <br />❑ Proposal Opening ® C/O & PCA No. 1 ❑ PCA <br />❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution <br />n Other: n Ease./Encroach <br />Information <br />Company or Vendor Name <br />Walsh and Kelly, Inc. <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />New Vendor <br />® No <br />MBE Yes <br />MBE/WBE Contractor <br />Completed E-Verify Form Attached <br />❑ ❑ No <br />Project Name <br />Tutt Street Brick Recovery <br />Project Number <br />120-045 <br />Funding Source <br />DCI Admin — Other Prof Services <br />Account No. <br />211-10-101-120-431000 <br />Amount <br />$2,894.00 <br />Terms of Contract <br />Purpose/Description <br />This change order adds landscaping/site restoration for disturbed areas. <br />For Change Orders Only <br />Amount of ® Increase $ 2,894.00 <br />❑ Decrease ($ ) <br />Previous Amount <br />$ 20,995.00 <br />Increase <br />Current Percent of Change: <br />Decrease <br />New Amount <br />$ 23,889.00 <br />Increase <br />Total Percent of Change: <br />Decrease <br />Time Extension Amount: <br />New Combletion Date: <br />13.78% <br />13.78% <br />