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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 04-06-2021 <br />Name: Jacob M. Klosinski Department of Public Works – Engineering Division <br />BPW Date: 04-13-2021 Phone Extension: Ext. 9496 <br /> <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Clara McDaniels <br />Dept. Attorney Attorney Name Clara McDaniels <br /> <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. Traffic Control Resolution <br /> Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name Selge Construction Company, Inc. (Niles, Michigan) V-00001471 <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 CSO 3 Backwater Valve Replacement <br />Project Number 119-113 <br />Funding Source Utilities, Sewage Works Operations, Contractual Services Other <br />Account No. 641-06-605-514-439001 (PO-0000767) <br />Amount $109,925.00 (Final Cost) <br />Terms of Contract Lump Sum NTE <br />Purpose/Description The Division of Engineering and Division of Utilities recommends approval <br />and acceptance of the Project Completion Affidavit and Maintenance Bond <br />for the subject project. All work was completed on schedule. <br />For Change Orders Only <br />Amount of <br /> <br />Increase <br />Decrease <br />$ <br />($ ) <br />Previous Amount $ <br />Current Percent of Change: <br />Increase <br />Decrease <br />% <br />(%) <br /> New Amount $ <br />Total Percent of Change: <br />Increase <br />Decrease <br />% <br />(%) <br /> Time Extension Amount: <br />New Completion Date: <br />