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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />June 1, 2018 <br />Jacob M. Klosinski <br />Purchasing <br />Department Utilities Wastewater <br />® *AI Greek. Director of Utilities <br />❑ Agreement <br />❑ <br />Contract Ll Proposal LJ Addendum <br />® Professional Services <br />❑ <br />Resolution <br />❑ <br />Bid Opening <br />❑ <br />Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ <br />Quote Opening <br />❑ <br />Quote Award <br />❑ <br />Change Order No. <br />❑ <br />CIO & PCA No. ❑ PCA <br />❑ Ease/Encroach. <br />❑ <br />Traffic Control <br />R Other: <br />- <br />Company or Vendor Name Kil Architecture and Planning <br />New Vendor ❑ Yes ® No ❑ If Yes, Approved by Purchasing <br />MBEIWBE Contractor ❑ MBE ❑ WBE <br />MBEMIBE Contractor Requested ❑ No ❑ Yes Name of Company <br />Wastewater Treatment Plant - Administration Building Masonry <br />Project Name Improvements <br />Project Number <br />Funding Source 2018 Utilities, Wastewater, Engi.neering Account <br />Account No. 641-0630-793-31-02 <br />Amount $ 36,200.00 <br />Terms of Contract Lump Sum (Itemized Scope) <br />Purpose/Description The Division of Utilities recommends the approval of a Professional <br />Services Agreement with Kil Architecture and Planning to provide <br />architectural and design services for the subject promect. See <br />agreement for balance of information. <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)-__ <br />Amount of ❑ Increase $ <br />❑ Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy Original <br />® ❑ Al Greek, Director of Utilities <br />® ❑ Jacob M. Klosinski, Assistant City Engineer <br />® ❑ ,Director of Financial Services, Environmental Services <br />