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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date lucre-1 2019 <br />Name Scott <br />Department Public <br />Works <br />BPW Date .tune 11 019 Phone Extension 9245 <br />uuumowev�r�:.. m �.... umu rm ....... . io UMMMmmmmmmmmm <br />Required Prior to Submittal to Board <br />BPW Attorney Attorney Name Clara McDaniels <br />Dept. Attorney F-1 Attorney Name <br />Purchasing ® Michael Schmidt <br />Check the Appropriate Item TYR S-- 1 e l! <br />E] Professional Services Agreement ❑ Contract <br />E] Open Market Contract 0 Amendment/Addendum <br />❑ Bid Opening Z Bid Award <br />Quote Opening E] Quote Award <br />El Proposal Opening ❑ C/O & PCA No. <br />E] Chg. Order, No. ❑ Traffic Control <br />El Other: <br />Reeured Information <br />All Submissions <br />LJ Proposal <br />❑ Special Purchase, QPA <br />❑ Req. to Advertise <br />❑ Reject Bids/Quotes <br />❑ PCA <br />Resolution <br />Ease./Encroach <br />❑ Title Sheet <br />Company or Vendor Name <br />Walsh & ell. ����_.............................................................._�__a�.�. <br />❑ Yes❑ If Yes, Approved by Purchasing <br />New Vendor <br />No <br />MBE <br />MBE/WBE ContractorI <br />MBE Completed E-Verify Form Attached <br />Nos <br />Project Name <br />2019 CornmUnrt Crossings <br />Project Number <br />119-015 <br />Funding Source <br />....._........................................................................... �Y <br />LRSA <br />Account No. <br />251-0608-431...�4�2._.�9.6...............................................................��_w � ��..m.m.m.......mw �. <br />Amount <br />$1,106,505.95 <br />Terms of Contract <br />Unit Price <br />Purpose/Description <br />_ <br />Award of bids for the mill and fill of various roadwaysmh within the <br />i City <br />of South Bend. <br />For Change Orders Only _....... _..._ <br />�. . <br />Amount of <br />Increase $ _w <br />❑ <br />Decrease ($ <br />Previous Amount <br />$ <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />New Completion Date: <br />$ <br />Increase % <br />Decrease .. .... .............. o/... <br />0 <br />Increase % <br />Decrease ( % <br />