Dedicated Improvements Agreement - Terms for City Water and Sewer Extension and Dedication of Dylan Dr. - GLC Portage Prairie IV, LLC

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 9/16/20 Department Name Kyle Silveus Engineering BPW Date 9/22/20 Phone Extension 9083 Review and Approval Required Prior to Submittal to Board Diversity Compliance and Inclusion Officer ❑ Officer Name BPW Attorney ❑ Attorney Name Clara McDaniels Dept. Attorney ❑ Attorney Name Purchasing ❑ Check the Appropriate Item Type — Required for All Submissions ❑ Professional Services Agreement ❑ Contract ❑ Proposal ❑ Open Market Contract ❑ Amendment/Addendum ❑ Special Purchase, QPA ❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ® Title Sheet ❑ Quote Opening ❑ Quote Award ❑ Reject Bids/Quotes ❑ Proposal Opening ❑ C/O & PCA No. ❑ PCA ❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution ® Other: Dedicated ❑ Ease./Encroach Improvements A reeement Required Information Company or Vendor Name GLC Portage Prairie IV, LLC New Vendor MBE/WBE Contractor Proj ect Name Project Number Funding Source Account No. Amount Terms of Contract U YesU If Yes, Approved by Purchasing ❑ No El ❑ MBBE ❑ Completed E-Verify Form Attached ❑ Neos Dylan Dr. Extension — Dedicated Improvements Agreement DP 19-073 N/A N/A N/A Purpose/Description Outlines terms for the extension of City Water and Sewer per attached plans and the terms for the dedication of Dylan Dr. The Title sheet is also include for signatures. For Change Orders Only Amount of ❑ Increase $ ❑ Decrease ($ ) Previous Amount $ Current Percent of Change New Amount Total Percent of Change: Time Extension Amount: Increase % Decrease ( %) Increase % Decrease ( %)