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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 09-17-2021 <br />Name: Jacob M. Klosinski, P.E.Department of Public Works – Engineering Division <br />BPW Date: 09-28-2021 Phone Extension: 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. 1 PCA <br /> Chg. Order, No. Traffic Control Resolution <br /> Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name Selge Construction Company, 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 CSO 35 Throttle Pipe Replacement <br />Project Number 120-042 <br />Funding Source <br />Account No. PR-00002053/PO # 0006388 <br />Amount See Below <br />Terms of Contract Lump Sum / Unit Prices <br />Purpose/Description Change Order No. 1 addresses underrun and overrun quantities for the subject <br />project resulting in a net deduct of $14,057.50. See summary below and <br />Memorandum for details. <br />For Change Orders Only <br />Amount of <br /> <br />Increase <br />Decrease <br />$ <br />($ 14,057.50) <br />Previous Amount $ 148,787.50 <br />Current Percent of Change: <br />Increase <br />Decrease <br />% <br />(-9.45%) <br /> New Amount $ 134,730.00 <br />Total Percent of Change: <br />Increase <br />Decrease <br />% <br />(-9.45%) <br /> Time Extension Amount: 0 days <br />New Completion Date: 05/31/2021 (Note: Work Completed 05/26/2021) <br />