Change Order No 2 - North Station Well No 1 Replacement Project No 117-031R - Peerless Midwest Inc

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date9/03/19.................................................�....................._ Department Public Name Becca Plantz Works BPW Date 9/10/19 Phone Extension 5998 >gu m mr �m� Hi uu�flffi�mm mmm 91110 wummmmm w ..._..................... ...... ......,.., ....._..........._A....._...... ........ .. �..._..._._ l uired Prior to Submittal to Board ..........._ ......J ........... ................. �...... BPW Attorney Attorney Name Dept. Attorney F-1 Attorney Name Purchasing I:] Check the Item Type — Requar ed,1 r All Submissions Professional Services Agreement ❑ Contract Open Market Contract ❑ Amendment/Addendum Bid Opening 17' Bid Award F-1 Quote Opening ❑ Quote Award Proposal Opening ❑ C/O & PCA No. ® Chg. Order, No. 2 F-1 Traffic Control ❑ Other: Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description Information L..j Proposal Special Purchase, QPA ❑ Req. to Advertise ❑ Reject Bids/Quotes ❑ PCA 0 Resolution Ease./Encroach ❑ Title Sheet Peerless Midwest El Yes If Yes, Approved��.... ............. ❑ by Purchasing E] No MBE Completed E-Verify Form Attached ❑ Nos WBE hNortStation Well No. 1 Replacement 117-031R Water Works 62206406614602 Lump Sum _. ,For Cl�a��gc Orders f��y Amount of Increase $ 1,345.00 � �.... ...... � ............ ... a. _ �� .........�.�. Decrease J ) Previous Amount $ 542,225.72 ................�.��.�_��._..... ... ��____.................�.......................m�_. Increase 0.25 Current Percent of Change: Decrease .... .e_ (0%...........� New Amount $ 543,570.72 .Increas.e......................ww__ 2.03% Total Percent of Change: Decrease 0 /o Time Extension Amount: 0 New Completion Date: 12/21/2019