Bureau of Indian Affairs ROW Application - Additional Utility Easement – US Dept. of Interior Bureau of IN Affairs

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 3/15/2022 Name Sue Ellen Doudrick Department DPW BPW Date 3/22/2022 Phone Extension 5922 Review and Approval Required Prior to Submittal to Board Diversity Compliance and Inclusion Officer Officer Name BPW Attorney Attorney Name Dept. Attorney Attorney Name Purchasing Check the Appropriate Item Type – Required for All Submissions Professional Services Agreement Contract Proposal Open Market Contract Amendment/Addendum Special Purchase, QPA Bid Opening Bid Award Req. to Advertise Title Sheet Quote Opening Quote Award Reject Bids/Quotes Proposal Opening C/O & PCA No. __ PCA Chg. Order, No. Traffic Control Resolution Other: BIA Right of Way Agreement Ease./Encroach Required Information Company or Vendor Name US Department of Interior Bureau of Indiana Affairs New Vendor Yes If Yes, Approved by Purchasing No MBE/WBE Contractor MBE WBE Completed E-Verify Form Attached Yes No Project Name Prairie Avenue Water Main Extension by Star 001 Project Number DP 18-025 Funding Source n/a Account No. n/a Amount n/a Terms of Contract ROW Agreement with BIA Purpose/Description The purpose of the BIA Right of Way Application is to acquire the additional utility easement on the Pokagon Band’s property that is required as part of the water main extension from the Band’s property on Prairie Avenue to the Star 001 development. The easement was required as part of the 4-party Easement Agreement approved at the board on 12/17/2020. For Change Orders Only Amount of Increase Decrease ($) Previous Amount Current Percent of Change: Increase Decrease (%) New Amount Total Percent of Change: Increase Decrease (%)