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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 10/31/2024 <br />Name Becca Plantz Department Public Works <br />BPW Date l l /l 2/2024 Phone Extension 5998 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance ❑ Officer Name Cynthia Simmons <br />and Inclusion Officer <br />BPW Attorney <br />❑ Attorney Name <br />Dept. Attorney ❑ Attorney Name <br />Purchasing ❑ Mickey Lovey <br />Michael Schmidt <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 />n Other: n Ease./Encroach <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Information <br />Larson Danielson Construction Co., Inc. <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />❑ No <br />❑❑ ❑ <br />MBE Completed E-Verify Form Attached ❑ Yes <br />No <br />South Bend City Hall Renovation <br />124-001 <br />Economic Development LIT, TIF, Water & Sewer Capital <br />PROJ 362 <br />$7,327 <br />Lump Sum <br />Renovation and upgrades on mechanical, electrical, and plumbing systems in <br />the six -story tall former South Bend Community School Board office buildin€ <br />for the City of South Bend to utilize as their new City Hall including offices, <br />meetin,a spaces, and support areas. <br />Amount of ❑ Increase <br />❑ Decrease <br />Previous Amount $ <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />New Completion Date: <br />For Change Orders <br />Increase <br />Decrease <br />Increase <br />Decrease <br />