MOU for Reimbursement - American Electric Power - Reimbursement to City for Michigan St Project

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date August 5, 2019 Name Roger T. Nawrot Department Public Works Division/Bureau Engineering BPW Date August 13, 2019 Phone Extension 5932 imwwmw 000mmmmmmmoo oa�5555555555ommmmmmmmmm wmwmaumammw=w miff cuured Prior to Submittal to Board Legal ❑ Attorney Name: Controller ❑ Controller review is required for all Contracts $5,000.00 or more and greater than one year in length per the City Purchasing Policy Purchasing ❑ Check the Agreement ❑ Professional Services Bid Opening Quote Opening Change Order No. _ Ease/Encroach. Other: Company or Vendor Name �ropriate Item Type - ElContract El Resolution [� Bid Award Quote Award El C/O & PCA No,. Il Traffic Control: New Vendor MBE/WBE Contractor MBE/WBE Contractor Requested Project Name Project Number Funding Source Account No. Amount Terms of Contract !d for All Submissions E] Proposal E] Req. to Advertise ❑ PCA quired Information American Electric Power Comb El Yes �', No �_........ Purchasing ❑ MBE F W B E .❑ No ]: Yes Name of Comps _W . MichiganStreet Reconstruction 118-075 $129,135.00 Inc. Addendum ❑ Title Sheet If Yes, Approved by Purpose/Description Memorandum of Understandin for Reimbursement �,_�............ ....................... Required Contractor's Certification Forms Attached (Non- Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) Required For ChaggwwOrders Only+ Amount of ❑ Increase [� Decrease $ _ _ ........ . Previous Amount $ w _�.�...................... ........... ... Current Percent of Change: % New Amount $ Total Percent of Chance: % Copy Original