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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date March 16 2020 <br />Department <br />Name Jacob M. Klosinski En incerin g/1.1tilities <br />BPW Date March 24 2020 Phone Extension Ext. 9496 <br />Review and A !oval Re uiq red Prior to Submittal to Board <br />Diversity Compliance <br />and Inclusion Officer Officer Name <br />BPW Attorney Z Attorney Name Clara McDanicls <br />Dept. Attorney ® Attorney Name <br />Purchasing Z Michael Schmidt <br />Check the A t1rooriate Item Twe <br />Professional Services Agreement [...J Contract <br />Clara McDaniels <br />Open Market Contract <br />El <br />Amendment/Addendum <br />[� <br />Bid Opening <br />Fl <br />Bid Award <br />Quote Opening <br />❑ Quote Award <br />Proposal Opening <br />® C/O & PCA No. 1 <br />Chg. Order, No. <br />❑ Traffic Control <br />Other: <br />Information <br />]br All Submissions <br />[❑ Proposal <br />❑ Special Purchase, QPA <br />El Req. to Advertise ❑ Title Sheet <br />Reject Bids/Quotes <br />PCA <br />Resolution <br />F� Ease./Encroach <br />Company or Vendor Name Cornerstone Stewards, Inc. <br />New Vendor EI Yes❑ If Yes, Approved by Purchasing <br />® No <br />MBE/WBE Contractor MBE Completed E-Verify Form Attached No <br />Project Name WWTP Raw Sewage Pump No. 2 Rehabilitation <br />Project Number 118-020 <br />................. .W...........v _ .... _____ _--- <br />2018 Sewage Works Capital, Wastewater Treatment & Disposal Equip. & <br />Funding Source 2020 'Sewage Works Oaerations Other Equip. Repair & Maint. <br />Account No. 642-0630-415-43-66 and 641-0630-793-3605 for CO#1) <br />Amount _$380.833.00 Final Cost, +2.93% <br />Terms of Contract Lump Sum <br />Purpose/Description The Division of"1 tilities requests, the Board of Public Works arwroval of <br />Chan e Order 1 Final & the Project Completion Affidavit for 118-020. <br />For Change Orders On <br />Am. ... �.._ M_. <br />ount of FA increase $ 10,833.00 <br />Decrease <br />Previous Amount <br />$ 370,000.00 <br />...............................- <br />Increase 2.93% <br />Current Percent of Change: <br />Decrease ( % <br />New Amount <br />$ 380,833.00 <br />Increase 2.93% <br />Total Percent of Change: <br />Decrease (W % <br />Time Extension Amount: <br />0 days <br />