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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date December 13, 2021 <br />Name Leslie Biek, PE Department PW <br />BPW Date December 21, 2021 Phone Extension 9323 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance <br />and Inclusion Officer Officer Name <br />BPW Attorney Attorney Name <br />Dept. Attorney Attorney Name <br />Purchasing Ron O'Connor <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. 9-11, & 13 Traffic Control Resolution <br /> Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name INDOT (Contractor is Milestone) <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 Olive St Reconstruction Ph 1 <br />Project Number 114-064, PROJ 59 <br />Funding Source <br />Account No. P0-9357, <br />Amount $234,180.90Total (Local $46,836.18) <br />Terms of Contract <br />Purpose/Description See attached memo. <br />For Change Orders Only <br />Amount of Increase <br />Decrease <br />$234,180.90 Total (Local share is $46,836.18) <br />($ ) <br />Previous Amount $ 3,503,578.49 <br />Current Percent of Change: <br />Increase <br />Decrease <br />6.59% <br />( %) <br /> New Amount $3,792,762.43 <br />Total Percent of Change: <br />Increase <br />Decrease <br />13.61% <br />( %) <br /> Time Extension Amount: 48 Days <br />New Completion Date: 12/31/2021