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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />January 10, 2018 <br />Jacob M. Klosinski <br />Department Div. of Utilities (OR <br />BPW Date Janua 23, 2018 Phone Extension 574) 235-9496 <br />LJ Agreement <br />LJ Contract L Proposal Lj Addendum <br />® Professional Services <br />❑ Resolution <br />❑ Bid Opening <br />❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening <br />El Quote Award <br />❑ Change Order No. <br />❑ CIO & PCA No. ❑ PCA <br />❑ Ease/Encroach. <br />❑ Traffic Control <br />f lOther: <br />Company or Vendor Name Donohue and Associates <br />New Vendor ❑ Yes ® No ❑ if Yes, Approved by Purchasing <br />MBEIWBE Contractor ❑ MBE ❑ WBE <br />MBEIWBE Contractor Requested ® No ❑ Yes Name of Company <br />Project Name Wastewater Treatment Plant Belt Filter Press #4 Rehabilitation <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Utilities, Sewage Works/Wastewater, Engineering <br />641-0630-793-31-02 <br />$ 9,000.00 <br />Purpose/Description The Division of Utilities re nests the approval of a Professioaal <br />Services Agreement with Donohue & Associates to provide <br />engineering services for Specifications and Bidding services for the <br />WWTP Belt Filter Press #4 project. <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion. Non -Discrimination. Non -Debarment. E-Verifv. Iran. etc.) <br />Amount of ❑ Increase $ <br />❑ Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />