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Amendment No 1 to Traffic Signal Maintenance Agreement - Changes to Section 1.4, Part A – INDOT
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Amendment No 1 to Traffic Signal Maintenance Agreement - Changes to Section 1.4, Part A – INDOT
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2/10/2022 9:51:19 AM
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2/10/2022 9:51:14 AM
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Board of Public Works
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Contracts
Document Date
2/8/2022
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1
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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 01/27/2022 <br />Name: Eric Horvath Department of Public Works – Engineering Division <br />BPW Date: February 8, 2022 Phone Extension: <br /> <br />Required Prior to Submittal to Board BPW Attorney X Attorney Name <br />Dept. Attorney Attorney Name <br /> <br />Purchasing <br />Check the Appropriate Item Type – Required for All Submissions <br /> Professional Services Agreement Contract Proposal <br /> Open Market Contract x 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 INDOT <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 <br />Project Number <br />Funding Source <br />Account No. PR/PO # <br />Amount N/A <br />Terms of Contract Changes Regarding a Change to Pay for “On-Call” or “Standby” <br />Employees, Section 1.4, Part A <br />Special Contract Provisions <br />Purpose/Description <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 /> New Amount $ <br />Total Percent of Change: <br />Increase <br />Decrease <br /> % <br />( %) <br /> Time Extension Amount: <br />New Completion Date: <br />
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