Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 08/05/2024 <br />Name Rebecca Maenhout Department VPA <br />BPW Date 08/06/2024 Phone Extension 5996 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance ❑ <br />Officer Name <br />and Inclusion Officer <br />BPW Attorney ® Attorney Name Michael Schmidt <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ® Mickey Lovy <br />Check the Appropriate Item Type — <br />Professional Services Agreement ❑ Contract <br />❑ Open Market Contract <br />❑ Bid Opening <br />❑ Quote Opening <br />❑ Proposal Opening <br />❑ Chg. Order, No. <br />n 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 />❑ Amendment/Addendum <br />❑ Bid Award <br />® Quote Award <br />❑ C/O & PCA No. <br />❑ Traffic Control <br />Information <br />Milestone Fence LLC <br />All Submissions <br />U Proposal <br />❑ Special Purchase, QPA <br />❑ Req. to Advertise <br />❑ Reject Bids/Quotes <br />❑ PCA <br />❑ Resolution <br />Ease./Encroach <br />Yes❑ If Yes, Approved by Purchasing <br />® No <br />❑ MBE Completed E-Verify Form Attached <br />❑ WBE <br />Erskine Golf Course Fence Repair <br />N/A <br />PR-00031581 <br />201-11-201-201-436000 <br />Lump Sum Quote <br />Repair to Damage Fencing <br />For Change Orders Only <br />Amount of ❑ Increase $ <br />❑ Decrease ($ ) <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />Increase <br />Decrease <br />Increase <br />Decrease <br />❑ Title Sheet <br />❑ Yes <br />❑ No <br />New Comaletion Date: <br />