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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: June 14th, 2021 <br />Name: Finnian Cavanaugh Department of Public Works – Engineering Division <br />BPW Date: July 13th, 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. 1 PCA <br /> Chg. Order, No. Traffic Control Resolution <br /> Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name Selge Construction Co., 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 El Campito Water Tap Quote <br />Project Number 121-017 <br />Funding Source West Washington TIF <br />Account No. 422-10-102-121-431000—PROJ00000233 <br />Amount $15,325.00 (decrease from $17,725.00) <br />Terms of Contract NTE <br />Purpose/Description Project close out of El Campito Water Tap Quote, overall deduct <br />change order. <br />For Change Orders Only <br />Amount of <br /> <br />Increase <br />Decrease <br />$ <br />($ 2,400.00) <br />Previous Amount $ 17,725.00 <br />Current Percent of Change: <br />Increase <br />Decrease <br />% <br />(-13.54%) <br /> New Amount $ 15,325.00 <br />Total Percent of Change: <br />Increase <br />Decrease <br />% <br />(-13.54%) <br /> Time Extension Amount: 0 <br />New Completion Date: 4/30/2021 (original) <br />