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2. Riverside Drive Embankment_COA 2022-0225A
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2. Riverside Drive Embankment_COA 2022-0225A
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Last modified
3/16/2022 1:25:26 PM
Creation date
3/16/2022 1:21:09 PM
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South Bend HPC
HPC Document Type
Certification
HPC Local Historic District
iii. Riverside Drive
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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 9/30/2021 <br />Name Sue Ellen Doudrick Department Engineering <br />BPW Date 10/12/2021 Phone Extension 5903 <br /> <br />Review and Approval Required Prior to Submittal to Board Diversity Compliance <br />and Inclusion Officer Officer Name BPW Attorney 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 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: Right of Entries Ease./Encroach <br />Required Information <br />Company or Vendor Name TBD <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 Riverside Drive Bank Stabilization <br />Project Number 118-005B <br />Funding Source n/a <br />Account No. n/a <br />Amount n/a <br />Terms of Contract n/a <br />Purpose/Description Memo to BPW regarding right of entry documentation for the Riverside Drive <br />Bank Stabilization Project. <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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