Amendment No 1 to INDOT Local Public Agency Project Coordination Contract Phase I

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date December 21, 2021 Department Public Works Name Kyle Silveus Division/Bureau Engineering BPW Date January 11, 2022 Phone Extension 9083 Required Prior to Submittal to Board Legal Attorney Name: Clara McDaniels Controller Controller review is required for all Contracts $5,000.00 or more and greater than one year in length per the City Purchasing Policy Purchasing Michael Schmidt Check the Appropriate Item Type –Required for All Submissions Agreement Contract Proposal Addendum Professional Services Resolution Bid Opening Bid Award Req. to Advertise Title Sheet Quote Opening Quote Award Change Order No. C/O & PCA No. PCA Ease/Encroach. Traffic Control: Other: INDOT-LPA Required Information Company or Vendor Name Indiana Department of Transportation New Vendor Yes No If Yes, Approved by Purchasing MBE/WBE Contractor MBE WBE MBE/WBE Contractor Requested No Yes Name of Company Project Name Coal Line Trail Phase 1 Project Number ENG: 115-063 DES No: 1401810 Funding Source Riverwest TIF Account No. 324-444000 Amount N/A Terms of Contract Purpose/Description Amendment of INDOT/LPA contract to extend the terms and schedule Required Contractor’s Certification Forms Attached (Non- Collusion, Non-Discrimination, Non-Debarment, E-Verify, Iran, etc.) Required For Change Orders Only Amount of Increase Decrease $ $ Previous Amount $ Current Percent of Change: % New Amount $ Total Percent of Change: % Dispersal After Approval Copy Original Kyle Silveus Chris Dressel Finn Cavanaugh