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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 04-29-2025 <br />Name: Jacob M. Klosinski Department of Public Works — Engineering Division <br />BPW Date: 05-13-2025 Phone Extension: Ext. 9494 <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Michael Schmidt <br />Dept. Attorney ® Attorney Name Michael Schmidt <br />Purchasing <br />® Mickey Low <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. 1 ❑ PCA <br />❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution <br />❑ Other: ❑ 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 />Special Contract Provisions <br />Purpose/Description <br />Amount of <br />El <br />Previous Amount <br />Information <br />HRP Construction, Inc. (V-00000775 <br />❑ Yes[] If Yes, Approved by Purchasing <br />® No <br />❑ WBE Completed E-Verify Form Attached ❑❑ Nos <br />Wastewater Treatment Plant Yard Piping Improvements — Contract A <br />123-031A (PROJ00000435 / PO-0030075) <br />642-06-605-514-442005 <br />PO-0030075 <br />See Below <br />Sum <br />The Division of Engineering and Division of Wastewater requests the Board <br />of Public Works approval of Change Order No. 1 and the project completion <br />affidavit for the subject project. All work is complete. Refer to Inter -Office <br />Memorandum and attachments for chan e order and completion affidavit. <br />For Change Orders Only <br />Increase $ 21,746.00 <br />Decrease ($ ) <br />$ 479,000.00 <br />Increase 4.54% <br />Current Percent of Change: <br />Decrease ( %) <br />New Amount <br />$ 500,746.00 <br />Increase 4.54% <br />Total Percent of Change: <br />Decrease ( %) <br />Time Extension Amount: <br />32 Days <br />New Completion Date: <br />08/15/2024 <br />