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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 02/11/2021 <br />Name: Finnian Cavanaugh Department of Public Works – Engineering Division <br />BPW Date: 02/23/2021 <br />Phone Extension: 5961 or <br />fcavanau@southbendin.gov <br /> <br />Required Prior to Submittal to Board BPW Attorney X Attorney Name Clara McDaniels <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. Traffic Control Resolution <br /> Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name Jones Petrie Rafinski Corp. <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 Ignition Park EV Charging Lot <br />Project Number 120-044 <br />Funding Source TIF River West Development <br />Account No. 324-10-102-121-431002--PROJ00000208 <br />Amount $6,200 increase (to new amount of $37,450) <br />Terms of Contract NTE <br />Purpose/Description Amendment to add services for survey and preparation of plans for <br />proposed replat of Ignition Park EV Charging site <br />For Change Orders Only <br />Amount of <br /> <br />Increase <br />Decrease <br />$ 6,200 <br />($ ) <br />Previous Amount $ 31,250 <br />Current Percent of Change: <br />Increase <br />Decrease <br />20% <br />( %) <br /> New Amount $ 37,450 <br />Total Percent of Change: <br />Increase <br />Decrease <br />20% <br />( %) <br /> Time Extension Amount: N/A <br />New Completion Date: <br />