Award Quote - Erskine Well #2 Rehabilitation - Peerless Midwest

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 11/19/2019 Department Public Name Becca Plantz Works BPW Date 11/26/19 Phone Extension 5998 I� �i�'ed Prior to Submittal to Board BPW Attorney ® Attorney Name Clara McDaniels Dept. Attorney []I Attorney Name Purchasing _._.... ❑ ppriateItem Check the App Type m Rqquire )r All Submissions F] Professional Services Agreement Contract] Proposal n Open Market Contract ❑ Amendment/Addendum E] Special Purchase, QPA [] Bid Opening E] Bid Award ❑ Req. to Advertise ❑ Title Sheet E' Quote Opening E Quote Award F-1 Reject Bids/Quotes ❑ Proposal Opening ❑ C/O & PCA No. ❑ PCA Chg. Order, No. ❑ Traffic Control ❑ Resolution Other ] Ease./Encroach w —Rouired; Information Company or Vendor Name Peerless Midwest E] .. Yes❑ If Yes, Approved by Purchasing ............. __ New Vendor No MBE/WBE Contractor E] MBE Completed E-Verify Form Attached ❑ ❑ Nos Project Name Erskine Well #2 Rehabilitation Project Number ................_ ITITITITIT........ ..-� 119-096 Funding Source __..................... Water Works — Source of Supply and Other Professional Services .... Account No. 620-0640-602-3106 Amount _._....... ------................ $64,600.00 . Terms of Contract Lump Sum Purpose/Description - .......................... ........ .................... Cleaning,inspection and motor replacement of well #2 at the Erskine Well Field. For Chage Orders Amount of ❑ Increase $ ❑ Decrease$ ) Previous Amount $ _ _ - �._._. .........-..... . Current Percent of Change: Decrease ( %) _............. .......... New Amount $ _.............. Increase % Total Percent of Change: Decrease ( %) Time Extension Amount: New Completion Date: