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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: <br />Name <br />September 9, 2020 <br />Finnian Cavanaugh Department of Public Works — Engineering Division <br />Phone Extension: 5961 or <br />BPW Date: September 22, 2020 fcavanau@southbendin.gov <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Clara McDaniels <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ❑ <br />Check the Appropriate Item Tvpe — Required for All Submissions <br />U Professional Services Agreement U Contract U 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 />n Other: n Ease./Encroach <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Information <br />Lawson -Fisher Associates <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />® No <br />E] MBE <br />❑ WBE Completed E-Verify Form Attached ❑❑ Yes <br />No <br />West Race Gate Repair <br />115-115 <br />Professional Services <br />101-06-600-500-431000-- <br />Addition of $25,600 — total agreement to equal $50,700 <br />NTE <br />Purpose/Description Design fees for restarting West Race Gate Repair project, including <br />updating of design, updating plans, updating permits, and repackaging as <br />a separate project from the West Bank Corridor Improvements. <br />For Change Orders Only <br />Amount of ❑ Increase $ <br />❑ Decrease ($ ) <br />Previous Amount $ <br />Increase % <br />Current Percent of Change: Decrease ( %) <br />New Amount $ <br />Increase % <br />Total Percent of Change: Decrease ( %) <br />Time Extension Amount: <br />New Completion Date: <br />