Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 02/22/2024 <br />Name: Patrick Sherman Department of Public Works — Engineering Division <br />BPW Date: 02/27/2024 Phone Extension: 5601 <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Michael Schmidt <br />Dept. Attorney ❑ Attorney Name Michael Schmidt <br />Purchasing ❑ Mickey Low <br />Check the Appropriate Item Type — Required. for 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. ❑ PCA <br />❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution <br />n Other: n Ease./Encroach <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 />Special Contract Provisions <br />Purpose/Description <br />Information <br />HWC En6neeriniz Inc. <br />❑ Yes[:] If Yes, Approved by Purchasing <br />® No <br />MBE ❑ WBE Completed E-Verify Form Attached Yes <br />❑ No <br />Walker Field Connectivity <br />123-058 <br />PO# 26221 <br />456-10-101-121-444000--PROJ00000455 <br />$212.500.00 <br />EJCDC Contract <br />N/A <br />Design Services for traffic calming and connectivity to Rum Village at <br />Walker Field Park. <br />For Change Orders Only <br />Amount of ❑ Increase <br />❑ Decrease ($ ) <br />Previous Amount $ <br />Increase <br />Current Percent of Change: Decrease <br />New Amount $ <br />Increase <br />Total Percent of Change: Decrease <br />Time Extension Amount: <br />New Completion Date: <br />