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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 3/4/2024 <br />Department Public <br />Name Scott Kree2er <br />BPW Date 3/12/2024 Phone Extension 9245 <br />Required Prior to Submittal to Board <br />BPW Attorney ® Attorney Name Michael Schmidt <br />Dept. Attorney ❑ Attorney Name <br />Purchasing <br />❑ 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. 1 ❑ 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 />Purpose/Description <br />Information <br />Milestone Contractors North, Inc. <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />® No <br />❑ WBE Completed E-Verify Form Attached ❑ Nos <br />2023 Concrete Repairs <br />123-022 <br />Southside TIF,LRS <br />251-06-600-506-436008, 430-10-102-121-442001 <br />$79,191.85 <br />Change Order #1: Subgrade stabilization on various roadways in project <br />For Change Orders OnI <br />Amount of ® Increase $ 79,191.85 <br />❑ Decrease ($ ) <br />Previous Amount $ 2,799,000 <br />Increase <br />Current Percent of Change: <br />Decrease <br />New Amount <br />$ 2,878,191.85 <br />Increase <br />Total Percent of Change: <br />Decrease <br />Time Extension Amount: <br />0 <br />New Completion Date: <br />2.83% <br />( <br />2.83% <br />