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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />ust 11. 2017 <br />Jacob M. Klosinski <br />Department Utilities Wastewater <br />Purchasing ® Carol Kurzhal <br />Check the. 'Approp riate Item Type ReouiredforAll Submissions <br />L J Agreement LJ Contract L] Proposal LJ Addendum <br />❑ Professional Services ❑ Resolution <br />❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening ❑ Quote Award <br />® Change Order No. 2 ❑ CIO & PCA No. ❑ PCA <br />❑ Ease/Encroach. ❑ Traffic Control <br />�I Other: <br />Company or Vendor Name HRP Construction, Inc. <br />New Vendor ❑ Yes ® No ❑ If Yes, Approved by Purchasing <br />MBEIWBE Contractor ❑ MBE ❑ WBE <br />MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company <br />Project Name Calvert Street Lift Station Replacement <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />116-053 <br />Wastewater Capital Account <br />642-0630-415-43-66 <br />Lump Sum and Unit Prices <br />Purpose/Description The Division of Utilities recommends the Board of Public Works <br />approval of Change Order No. 2 which includes changes to the <br />scope of work adjusted guantities, and 30-dayextension to Final <br />Completion (see Inter -Office Memorandum for Details). <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion. Non -Discrimination, Non -Debarment, E-Verifv. Iran, etc.) <br />Amount of ❑ increase $ <br />® Decrease $ 7,197.60, +30 Days to Final Completion (Utility Conflict) <br />Previous Amount $ 927,805.80 <br />Current Percent of Change:--0.78%; Previous +1.18%% <br />New Amount $ 920,608.20 <br />Total Percent of Change: +0.40% <br />Dispersal After Approval <br />Copy Original <br />® ❑ Al Greek, Director of Utilities <br />® ❑ Jacob M. Klosinski, Assistant City Engineer <br />® ❑ Carol Kurzhal, Director of Financial Services, Environmental Services <br />