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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date June 18 2019 <br />Department Legal on <br />behalf of DCI and <br />Name Sandra Kennedv VPA <br />BPW Date June 25 2019 Phone Extension 235-9294 <br />m�muuummm�muuuuuuuuuuuummmmmw.mmwimmmmmmmmi�uu uuuuumumuuuuuuuu lm mmmuuuumimomommmnmmmimimmmmmmimimmmimimmmmmmmimimmmmmmmmuimimimimimimmmmmmmmumommmmmm uuumommmmmummmmmummmmmumomommmimumimmmummmmmmmmmmmmmmmommmmmmmmmmmmmmmmmmimimmmmmmmmmmmmmmmmmimimmmmmuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuumiiiw� <br />..................................................._.................._�.._......_ ,..........,. ...........__..._.m�..�..�_..,.,.�..�.�....� .�......... ___.......... <br />Required Pnor tommSubmittal toBoard <br />........... <br />BPW Attorneymm�mmmmmm ._................._ AttorneyNameC1araITMcDaniels.._..�.�..�._...�._��._ <br />Dept. Attorney 0 Attorney Name Sandra Kennedy <br />Purchasing <br />Check the Apit Le <br />E Professional mServices Agreement Contract <br />❑ Open Market Contract ❑ Amendment/Addendum <br />[j Bid Opening [:] Bid Award <br />[-1 Quote Opening [] Quote Award <br />E] Proposal Opening [❑ C/O & PCA No. <br />EJ Chg. Order, No. Traffic Control <br />n Other: <br />r All Submissions <br />(I Proposal <br />❑ Special Purchase, QPA <br />0 Req. to Advertise <br />E]I Reject Bids/Quotes <br />[❑] PCA <br />E] Resolution <br />Ease./Encroach <br />❑ Title Sheei <br />Re , Ma ired Information <br />Companyor Vendor Name <br />University of Notre du Lac, Stephenson Mill <br />Unmmm ..............._.. <br />E]Yes ❑ If Yes, Approved by Purchasing <br />New Vendor <br />❑ No <br />❑ MBE Yes <br />MBE/WBE Contractor <br />Completed E-Verify Form Attached <br />❑ WBE [ No <br />Project Name <br />Seitz Park Improvements <br />_... _.................... �ww......................w............... ........... .......................... . ........................ _. ...... .......... . <br />Project Number <br />1..1..-0.9.3................... ............ ............. .......... <br />. <br />Funding Source <br />Account No. <br />Amount�..__$.�._.._.._..�.�.�.�......�.�.�.�.�.�.�.�.�......�.�.�......� <br />...........................ww��......................_.._...�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�.�............._..��.._......�.�.�.�.�.�.�..............................................................................�.�.�.. <br />�- <br />Terms of Contract <br />Duration of Seitz Park Im rovements� est. December 202_h <br />Purpose/Description <br />�.�.�_�.� �.�.�_� �� ..._. _ ._.__...........�.�.�.�.�.�.�.._-.�.�.�.. _ - <br />Project Agreement: This Agreement allows Notre Dame and the City to us <br />the parking lot around Stephenson Mill to effectuate the construction of No <br />Dame's hydroelectric facility and the improvements to Seitz Park by allowi <br />Notre Dame and the City to stae construction cc u�mat on the prapert� <br />..._...._..__.. <br />For '1 II Orders <br />.... ......... ..... ..._ ........ ... .�... <br />Amount of <br />Increase $ <br />Decrease ($ ) <br />Previous Amount <br />$ <br />...Increase ...........%.............. �...�.. .� <br />Current Percent of Change: <br />Decrease %) .......m_..wm_....._,.................. <br />�,......�.�.......�����..m. <br />New Amount <br />$ ._..............._................ .........................................—................�...... ���mm._.............. ���...... � �..... <br />Increase.—w.. <br />Total Percent of Change: <br />Decrease %) <br />Time Extension Amount: <br />New Completion Date: <br />�.___ <br />