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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 10-04-2021 <br />Name: Jacob M. Klosinski, P.E.Department of Public Works – Engineering Division <br />BPW Date: 10-12-2021 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. PCA <br /> Chg. Order, No. 001 Traffic Control Resolution <br /> Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name Slatile Roofing and Sheet Metal, Inc. (South Bend, Indiana) <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 WWTP Masonry Improvements Gallery Buildings 1-4 <br />Project Number 120-036 <br />Funding Source 641-06-605-514-436001 (Original PO); 642-06-605-514-442005 (CO#1) <br />Account No. PO # 0005683 <br />Amount See Below <br />Terms of Contract <br />Purpose/Description Change Order No. 1 addresses additional scope of work for replacing lintels, <br />removing embedded conduits, and removing abandoned boiler piping. See <br />summary below and Memorandum for details. <br />For Change Orders Only <br />Amount of <br /> <br />Increase <br />Decrease <br />$ 20,486.00 <br />($ ) <br />Previous Amount $ 420,218.00 <br />Current Percent of Change: <br />Increase <br />Decrease <br />+4.875% <br />(%) <br /> <br />New Amount $ 440,704.00 <br />Total Percent of Change: <br />Increase <br />Decrease <br />+4.875% <br />(%) <br /> <br />Time Extension Amount: <br />150 days (Delayed start of work due to Winter Weather; unforeseen <br />conditions and material supply delays) <br />New Completion Date: October 12, 2021 <br />