Change Order No. 1 - Project Completion Affidavit - WWTP Belt Filter Press No. 4 Rehabilitation Project No 117-025 - Alfa Laval Inc.

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Date Name BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM October 13, 2017 Jacob M. Klosinski Department Utilities Wastewater BPW Date October 24, 2017 Phone Extension (574) 235-9496 Required Prior to Submitfial to Board Legal ® Attorney Name Catherine Fanello 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 ® Carol Kurzhal H Agreement U Contract L_J Proposal U Addendum ❑ Professional Services ❑ Resolution ❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet ❑ Quote Opening ❑ Quote Award ❑ Change Order No. ® CIO & PCA No. 1, Final ❑ PCA ❑ Ease/Encroach. ❑ Traffic Control F- Other: Company or Vendor Name Alfa Laval (Houston, Texas) New Vendor ❑ Yes ® No ❑ if Yes, Approved by Purchasing MBEIWBE Contractor ❑ MBE ❑ WBE MBEIWBE Contractor Requested ❑ No ❑ Yes Name of Company Project Name Wastewater Treatment Plant Belt Filter Press #4 Rehabilitation Project Number 117-025 Funding Source 2017 Wastewater, Other Equipment Account No. 641-0630-793-36-05 Amount $ Terms of Contract Lump Sum Purpose/Description Utilities recommends the approval of Change Order No. 1 deduct of $5,000 for unused allowance) and the Project Completion Affidavit. All work is complete. ❑ Required Contractor's Certification Form Attached (Non - Collusion, Non -Discrimination. Non -Debarment. E-Verifv. Iran. etc.) Amount of ❑ Increase $ ® Decrease $ 5,000.00 Previous Amount $ 197,360.00 Current Percent of Change: New Amount Total Percent of Change: Copy Original -2.53% $ 192,360.00 -2.53% Dispersal After Approval Al Greek, Director of Utilities Jacob M. Klosinski, Assistant City Engineer Carol Kurzhal, Director of Financial Services, Environmental Services