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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date October 20, 2020 <br />Name Scott Kreeger <br />Department Public <br />Works <br />BPW Date October 27, 2020 Phone Extension 9245 <br />Required Prior to Submittal to Board <br />BPW Attorney Attorney Name Clara McDaniels <br />Dept. Attorney Attorney Name <br />Purchasing Michael Schmidt <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. 4 Traffic Control Resolution <br /> Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name Rieth-Riley Construction <br />New Vendor Yes If Yes, Approved by Purchasing <br /> No <br />MBE/WBE Contractor MBE <br />WBE Completed E-Verify Form Attached Yes <br /> No <br />Project Name Bendix Dr., Lathrop to Indiana Toll Road <br />Project Number 114-065 <br />Funding Source LRSA - Streets & Alleys <br />Account No. 251-06-600-506-442001 <br />Amount 4 days <br />Terms of Contract Unit Price <br />Purpose/Description __Change Order No. 4 for the vacation of the 12 in existing gas main on <br />Bendix Dr. Additional 4 days to intermediate completion <br />date._______________________________________________ <br />For Change Orders Only <br />Amount of Increase <br />Decrease <br />$ <br />($ ) <br />Previous Amount $ <br />Current Percent of Change: <br />Increase <br />Decrease ( %) <br /> New Amount $ <br />Total Percent of Change: <br />Increase <br />Decrease (%) <br /> Time Extension Amount: 4 days <br />New Intermediate Completion <br />Date: 9/27/2020