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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br /> <br />Date 1/28/22 <br />Name Leslie Biek, Assistant City Engineer Department PW <br />BPW Date 2/8/22 Phone Extension 9323 <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. 14 and Final Traffic Control Resolution <br /> Other: Recommendation for <br />Acceptance <br /> Ease./Encroach <br />Required Information <br />Company or Vendor Name INDOT (Contractor is Milestone) <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 Olive St Reconstruction Ph 1 <br />Project Number 114-064, PROJ 59 <br />Funding Source <br />Account No. P0-9357 <br />Amount $58,185.62 - No additional local funds needed <br />Terms of Contract <br />Purpose/Description Final balancing change order and recommendation for acceptance. <br />For Change Orders Only <br />Amount of <br /> <br />Increase <br />Decrease <br />$58,185.62 <br />($ ) <br />Previous Amount $ 3,796,759.83 <br />Current Percent of Change: <br />Increase <br />Decrease <br />1.74% <br />( %) <br /> New Amount $ 3,854,945.45 <br />Total Percent of Change: <br />Increase <br />Decrease <br />15.47% <br />( %) <br /> Time Extension Amount: <br />New Completion Date: