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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date09/03/2020 <br />Department Engineering/Fire <br />Name Alicia Czarnecki <br />BPW Date09/22/2020 Phone Extension 5903 <br /> <br />Required Prior to Submittal to Board <br />BPWAttorney Attorney Name <br />Dept. Attorney Attorney Name <br /> <br />Purchasing <br />Check the Appropriate Item Type Required for 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. 3 Traffic Control Resolution <br /> Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name Gibson-Lewis, LLC <br /> Yes If Yes, Approved by Purchasing <br />New Vendor <br /> No <br /> MBE Yes <br />MBE/WBE Contractor Completed E-Verify Form Attached <br /> WBE No <br />Project Name Fire Stations 3 & 6 Renovations <br />Project Number 118-047 <br />Funding Source FIRE CAPITAL IMPROVEMENTS / BUILDING IMPROVEMENT <br />Account No. 287-0902-422.42-02 <br />Amount <br />Terms of Contract <br />Purpose/Description South Bend Fire Stations 3 and 6 Renovations. <br />_______________________________________________________ <br />For Change Orders Only <br />$ 38,246.00 <br /> Increase <br />Amount of <br /> Decrease <br />Previous Amount $ 955,060.00 <br />4.00% <br />Increase <br />Decrease <br />Current Percent of Change: <br /> <br />New Amount $ 993,306.00 <br /> % <br />Increase <br />Decrease (-11.31%) <br />Total Percent of Change: <br /> <br />Time Extension Amount: <br />New Completion Date: <br /> <br />