Change Order No. 1 - Alfa Laval Inc. - WWTP Belt Filter Press #2

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date _September 19, 2016 Name Jacob M. Klosinski Department Div. of Env. Services BPW Date September 27, 2016 Phone Extension (574) 235-9496 Required Prior to Submittal to Board Legal ® Attorney Name Michael Schmidt Controller ® Controller review is required for all Contracts $5,000.00 or more and greater than one year in length per the City Purchasing Policy Purchasing Professional Services Bid Opening Quote Opening Change Order No. _ Ease/Encroach. Other: ® Carol Kurzhal Contract Resolution Bid Award Quote Award C/O & PCA No. 001 Traffic Control Company or Vendor Name Alfa Laval Proposal ❑ Req. to Advertise Information ❑ PCA Addendum ❑ Title Sheet New Vendor ❑ Yes ® No ❑ If Yes, Approved by Purchasing MBE/WBE Contractor ❑ MBE ❑ WBE Project Name Wastewater Treatment Plant - Belt Filter Press Rehabilitation Project Number 115-082 Environmental Services, Wastewater Repair & Maintenance Other Funding Source Equipment Account No. 641-0630-793-36-05 Amount $ Terms of Contract Purpose/Description The Division of Environmental Services recommends the Board of Public Works approval of Change Order No. 1 (deduct for unused construction allowance of $5,000) and the Project Completion Affidavit for Project No. 115-082 WWTP Belt Filter Press Rehabilitation. ❑ Required Contractor's Certification Form Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc. Required For Change Orders Only Amount of ❑ Increase $ ® Decrease $ 5,000.00 Previous Amount Current Percent of Change: New Amount Total Percent of Change: Copy Original ® ❑ Al Greek ® ❑ Jacob M. ® ❑ Carol Kui -2.65% Dispersal After Approval