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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />March 19, 2018 <br />Jacob M. Klosinski <br />Department Utilities - Wastewater <br />Purchasing ® Al Greek Director of Utilities <br />❑ Agreement <br />❑ Contract <br />❑ Proposal ❑ Addendum <br />® <br />Professional Services <br />❑ <br />Amendment <br />❑ <br />Bid Opening <br />❑ <br />Bid Award <br />❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening <br />❑ Quote Award <br />❑ Chg Order No. <br />❑ C/O & PCA No. <br />❑ PCA <br />❑ Ease./Encroach. <br />❑ Traffic Control <br />❑ <br />Resolution <br />I-1 <br />Other: <br />❑ <br />Claim <br />Company or Vendor Name <br />New Vendor <br />MBEIWBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Frost Engineering andConsultin <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />® No <br />❑ MBE Completed E-Verify ,Form Attached El Yes <br />❑ WBE ®No <br />Water Works -- North Pumping Station Structural Assessment <br />n/a <br />Water Works, Operations, Engineering <br />620-0640-658-31-02 <br />$7, 775.00 <br />Lump Sum <br />North Pumping Station building / basement was observed to have <br />significant groundwater seepage through existing masonry during <br />the recent flood event in late February/earlyFebruary/early March 2018. Frost <br />Fnaineerina will provide a structural assessment & repair plans. <br />Amount of ❑ Increase <br />Decrease <br />Previous Amount $ <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Time Extension: <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 />Emily Leyes, Director of Financial Services, Environmental Services <br />