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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 8/26/20 <br />Name Sue Ellen Doudrick/Rebecca Plantz <br />Department Egg. <br />BPW Date 9/8/20 <br />Phone Extension 5922 <br />Required Prior to Submittal to Board <br />BPW Attorney ® <br />Attorney Name <br />Clara McDaniels <br />Dept. Attorney ❑ <br />Attorney Name <br />Purchasing ® <br />Michael Schmidt <br />Check the Appropriate <br />Item Type <br />— Re uired or All Submissions <br />❑ Professional Services Agreement ❑ Contract ❑ Proposal <br />❑ Open Market Contract ® Amendment/Addendum ❑ Special Purchase, QPA <br />❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening ❑ Quote Award ❑ Reject Bids/Quotes <br />❑ Proposal Opening ❑ C/O & PCA No. ❑ PCA <br />❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution <br />❑ Other: ❑ Ease./Encroach <br />Required Information <br />Company or Vendor Name <br />Christopher B. Burke Engineering, LLC <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />New Vendor <br />® No <br />Yes <br />MBE <br />MBE/WBE Contractor <br />Completed E-Verify Form Attached <br />❑ ❑ No <br />Project Name <br />South Bend Dam 2020 DSSMR <br />Project Number <br />119-112 <br />Funding Source <br />Stormwater Funds <br />Account No. <br />667-06-605-517-442002 <br />Amount <br />$14,200 <br />Terms of Contract <br />HNTE <br />Purpose/Description <br />Emergency Action Plan Exemption, assistance with preparing quote package <br />for river level gauges and dam safety signage, underwater inspection <br />previously approved in Amendment 41 was to be performed by Gus <br />Commercial Divers who is no longer in business. JF Brennan Company will <br />perform this effort. <br />For Change Orders Only <br />Amount of ❑ <br />Increase $ <br />❑ <br />Decrease ($ ) <br />Previous Amount <br />$ <br />Increase % <br />Current Percent of Change: <br />Decrease ( %) <br />New Amount <br />$ <br />Increase % <br />Total Percent of Change: <br />Decrease ( %) <br />Time Extension Amount: <br />New Combletion Date: <br />