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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 01-04-2022 <br />Name: Jacob M. Klosinski, P.E.Department of Public Works – Engineering Division <br />BPW Date: 01-11-2022 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. Traffic Control Resolution <br /> Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name HRP Construction, Inc. (V-00000775) <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 Edison Road Lift Station Valve Replacements <br />Project Number 121-068 <br />Funding Source Sewage Works Operations; Services & Charges; Other Rep. & Maint. <br />Account No. 641-06-605-514-436005 (PR-00011838; PO-0012468) <br />Amount $52,350.00 – Final Cost <br />Terms of Contract Lump Sum <br />Purpose/Description The Division of Engineering and Division of Utilities recommend approval of <br />a Project Completion Affidavit for the subject project. All work was <br />completed in 2021 as scheduled. <br />For Change Orders Only <br />Amount of <br /> <br />Increase <br />Decrease <br />$ <br />($ ) <br />Previous Amount $ <br />Current Percent of Change: <br />Increase <br />Decrease <br />% <br />(%) <br /> <br />New Amount $ <br />Total Percent of Change: <br />Increase <br />Decrease <br />% <br />(%) <br /> <br />Time Extension Amount: <br />New Completion Date: <br />