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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 3/20/23 Department Public Works <br />Name Rebecca Maenhout Division/Bureau Engineering <br />BPW Date 03/28/2023 Phone Extension 5996 <br />Required Prior to Submittal to Board <br />Legal Attorney Name: Micheal Schmidt <br />Controller Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing Michael Schmidt <br />Check the Appropriate Item Type – Required for All Submissions <br /> Agreement Amendment Contract Proposal Addendum <br /> Professional Services Resolution <br /> Bid Opening Bid Award Req. to Advertise Title Sheet <br /> Quote Opening Quote Award <br /> Change Order No. C/O & PCA No. PCA <br /> Ease/Encroach. Traffic Control: <br /> Other: <br />Required Information <br />Company or Vendor Name Ziolkowski Construction <br />New Vendor <br /> Yes No If Yes, Approved by <br />Purchasing <br />MBE/WBE Contractor MBE WBE <br />MBE/WBE Contractor Requested No Yes Name of Company <br />Project Name Seitz Park Reconstruction <br />Project Number 117-093A <br />Funding Source PO - 0006342 <br />Account No. 436-10-102-121-444000--PROJ00000079 <br />Amount $146,207.00 <br />Terms of Contract <br />Purpose/Description <br /> Change Order 8 covers the cost of extra work in Divisions B, C, D, and E <br />that were necessary due to unforeseen site conditions and design changes. <br />Add 2 days to final completion date. (New Date: August 9, 2023). <br /> Required Contractor’s Certification Forms Attached (Non- <br />Collusion, Non-Discrimination, Non-Debarment, E-Verify, Iran, etc.) <br />Required For Change Orders Only <br />Amount of Increase <br />Decrease <br />$ 146,207.00 <br />$ <br />Previous Amount $ 9,025,679.78 <br />Current Percent of Change: 1.2 % <br />New Amount $ 9,171,886.78 <br />Total Percent of Change: 28.486% <br />Dispersal After Approval <br />Copy Original <br />8X <br />X