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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 02/25/2021 <br />Name Becca Plantz Department Public Works <br />BPW Date 03/09/2021 Phone Extension 5998 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance <br />and Inclusion Officer Officer Name Michael Patton <br />BPW Attorney Attorney Name Clara McDaniels <br />Dept. Attorney Attorney Name <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. 1 Traffic Control Resolution <br />Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name Peerless Midwest, Inc. <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 Edison Well #4 Refurbishment – Well Cleaning <br />Project Number 120-060 <br />Funding Source Services & Charges-Repairs & Maint-Other Equip R&M <br />Account No.PR-00005227 <br />Amount <br />Terms of Contract Lump Sum <br />Purpose/Description Inspect, clean, and rehab Well #4 at Edison Filtration Plant. <br />For Change Orders Only <br />Amount of Increase <br />Decrease <br />$ 9,617.00 <br />($ ) <br />Previous Amount $ 71,400.00 <br />Current Percent of Change: <br />Increase <br />Decrease <br />13.47% <br />(%) <br />New Amount $ 81,017.00 <br />Total Percent of Change: <br />Increase <br />Decrease <br />13.47% <br />(%) <br />Time Extension Amount: <br />New Completion Date: