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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date October 20, 2020 <br />Department Public <br />Name Scott <br />BPW Date November 10, 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. 3 ❑ Traffic Control ❑ Resolution <br />n Other: n Ease./Encroach <br />Information <br />Company or Vendor Name Rieth-Riley Construction <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 />Purpose/Description <br />❑ Yes❑ If Yes, Approved by Purchasing <br />® No <br />❑ WBE Completed E-Verify Form Attached ❑❑ Yes <br />No <br />Bendix Dr., Lathrop to Indiana Toll Road <br />114-065 <br />LRSA - Streets & Alleys <br />251-06-600-506-442001 <br />$833.36 (20% of $4,166.80) <br />Unit Price <br />Additional costs for the excavation and grading at Bendix between Sugar <br />Maple and Nimtz Parkway due to fiber optic lines. <br />For Change Orders Only <br />Amount of ❑ Increase $ 4,166.8 <br />❑ Decrease ($ ) <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />New Intermediate Completion <br />Date: <br />$ 4,091,930.23 INDOT TOAL <br />Increase 0.102% <br />Decrease % <br />$ 4,096,097.03 <br />Increase 0.174% <br />Decrease °/( o) <br />5 days <br />9/23/2020 <br />