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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date November 20, 2017 <br />Name Jacob M. Klosinski Department <br />Utilities - Wastewater <br />BPW Date November 28, 2017 Phone Extension (574) 235-9496 <br />Re aired Prior to Submittal to Board <br />... <br />Legal ® Attorney Name Catherine Fanello <br />Controller ® Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing <br />® Carol Kurzhal <br />H Agreement <br />❑ Contract I I Proposal ❑ Addendum <br />❑ Professional Services <br />jl <br />Resolution <br />❑ Bid Opening <br />® <br />Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening <br />❑ Quote Award <br />❑ Change Order No. <br />❑ C/O & PCA No. ❑ PCA <br />❑ Ease/Encroach. <br />❑ Traffic Control <br />n Other: <br />Company or Vendor Name John Boettcher Sewer & Excavating <br />New Vendor ❑ Yes ® No ❑ If Yes, Approved by Purchasing <br />MBEIWBE Contractor ❑ MBE ❑ WBE <br />MBENVBE Contractor Requested ❑ No ® Yes Name of Company State Barricading, Inc. <br />Project Name Farmington 14A Lift Station Rehabilitation <br />Project Number 117-027 <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Utilities, Wastewater Capital <br />642-0630-415-43-66 <br />$ 360,577,79 <br />Lumo Sum land Unit Prices) <br />Purpose/Description Utilities requests the Board of Public Works approval to Award the <br />subject project to the lowest, responsive, responsible bidder John <br />Boettcher Sewer & Excavating <br />® Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verifv, Iran, etc.) <br />Amount of <br />Previous Amount <br />" Increase <br />❑ Decrease <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Copy <br />Original <br />® <br />❑ <br />® <br />❑ <br />® <br />❑ <br />Dispersal After Approval <br />-Al Greek, Director of Utilities <br />Jacob M. Klosinski, Assistant City Engineer <br />Carol Kurzhal. Director of Financial Services, Environmental Services <br />