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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 05/03/2024 <br />Name Becca Plantz Department Public Works <br />BPW Date 05/14/2024 Phone Extension 5998 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance <br />and Inclusion Officer Officer Name Cynthia Simmons <br />BPW Attorney Attorney Name Michael Schmidt <br />Dept. Attorney Attorney Name <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: Ease./Encroach <br />Required Information <br />Company or Vendor Name St. Joseph County Board of Commissioners <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 Douglas Road Utility Relocation <br />Project Number 118-116 <br />Funding Source DA TIF, Sewer Capital, Water Capital <br />Account No. PROJ-21, PO-7521 <br />Amount Original $300,517.13; Amendment $348,433.60; <br />Final Amount $648,950.73 <br />Terms of Contract Lump Sum <br />Purpose/Description Amendment to the City 20/County 80 agreement for the construction costs for <br />Douglas Road utility relocations and a new lift station. <br />For Change Orders Only <br />Amount of Increase <br />Decrease ($ ) <br />Previous Amount $ <br />Current Percent of Change: <br />Increase <br />Decrease ( %) <br /> New Amount $ <br />Total Percent of Change: <br />Increase <br />Decrease ( %) <br />Time Extension Amount: <br />New Completion Date: