MOU - MACOG - Traffic Data Collection for City of SB

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 10/10/19 Name Alicia Czarnecki Department Engineering ..... ...... . ................................... BPW Date 10/22/19 Phone Extension 5903 F:77/ BPW Attorney Attorney Name Dept. Attorney Attorney Name Purchasing r-1 H Professional Services Agreement LJ Contract LJ Proposal [] Open Market Contract ❑ Amendment/Addendum ❑ Special Purchase, QPA F-1 Bid Opening 0 Bid Award Req. to Advertise ❑ Title Sheet E] Quote Opening El Quote Award E] Reject Bids/Quotes E] Proposal Opening n C/O & PCA No. PCA 0 Chg. Order, No. E] Traffic Control ❑ Resolution F1 Other: Agreement F-1 Ease./Encroach Company or Vendor Name MACOG EJ Yes E] If Yes, .. Approved . . . . . by Purchasing .. . ... ............... New Vendor [:] No El MBE ❑ Yes MBE/WBE Contractor Completed E-Verify Form Attached FIWBE ❑ No Project Name MACOG MOU for Traffic Data Collection Project Number .. ............... . ........... N/A Funding Source LRSA — Professional Services Account No. .... ....... . . . . . . ........... . . ................... .. .. . 251-0608-431.31-06 . . .......................... ... Amount $28,000.00 . ......... - . .............. Terms of Contract Purpose/Description . . ...... ...................... ..... . ............................ Traffic count data collected by MACOG for Citv of South Bend, See attachment for a list of sites. --- ------- Amount of F-1 $ Increase . . .......... . .. . ............................. ................................ ...... . . . . El Decrease ($ Previous Amount ..................... ... . ....... Increase % Current Percent of Change: Decrease %) ... . . . ............................. New Amount Increase % Total Percent of Change: Decrease %) Time Extension Amount: ......... . New Completion Date: .. . . . ................ . ........... ..................