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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />...................................... <br />Date 4-1-19 <br />Name Scott Horvath Department Water <br />BPW Date 4-9-19 Phone Extension 574-235-5665 <br />mm umuwuumWumm: m mmumomuimmmmmmmimmmuuuuuummmu i i mm� <br />_._.._u___....�.u. .......... _��...—._ <br />Nuired Prior to Submittal to Board <br />BPW Attorney ® Attorney Name <br />Dept. Attorney E Attorney Name <br />Purchasing H <br />__ _Check the Appropriate Item lType R1� t� <br />Professional Services ..... Agreement Contract <br />Open Market Contract ❑ Amendment/Addendum <br />�] Bid Opening F-I Bid Award <br />Quote Opening El Quote Award <br />❑ Proposal Opening F-� C/O & PCA No. <br />FI Chg. Order, No. Traffic Control <br />Other: <br />l eauired Information <br />All Submissions <br />Proposal <br />] Special Purchase, QPA <br />Req. to Advertise <br />❑ Reject Bids/Quotes <br />❑ PCA <br />F] Resolution <br />Ease./Encroach <br />❑ Title Sheet <br />Company or Vendor Name American Leak Detection <br />New Vendor �] Yes❑ If Yes, Approved by Purchasing <br />No <br />MBE/WBE Contractor MBE WBE Completed E-Verify Form Attached ❑ Nos <br />Project Name South Bend Water Leak Survemmmmmmmmmmmmm. <br />Project Number <br />Funding Source Water Works Operating Fund <br />Account No. 620-0640-605-31-06 <br />Amount $ 74,000.00 <br />w� .............................. .._... <br />Terms of Contract Until 10-1-19 <br />Purpose/Description Detectionof leaks on 500 miles of the distribut_...........y ..... T ..,.,_,,.,.,.,..,ion sy <br />stem. ystem. They will <br />correlate leaks on water mains, hydrants, valves and service lines. Preferre( <br />Vendor. We were only able to attain two quotes in the process. <br />......__. ..___ <br />For Chan Orders <br />Amount of <br />Increase $ <br />El <br />Decrease ($ ) <br />• <br />Previous Amount <br />m. _.............................................................__......__..�.�......�...__...... <br />$ <br />Increase <br />% <br />Current Percent of Change:: <br />Decrease <br />( %) <br />New Amount <br />$ <br />Increase <br />% <br />Total Percent of Change: <br />Decrease <br />( %) <br />Time Extension Amount: <br />.............._...�..... �..._. <br />New Completion Date: <br />