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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 08/29/2025 <br />Name: Becca Plantz Department of Public Works — Engineering Division <br />BPW Date: 09/09/2025 Phone Extension: <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name <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. 2 ❑ 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 />Special Contract Provisions <br />Information <br />Larson Danielson Construction Com <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />® No <br />❑ WBE Completed E-Verify Form Attached ❑ Nos <br />South Bend City Hall Renovation <br />124-001 <br />Economic Development LIT, TIF, Water & Sewer Capital <br />PROJ 362 <br />Purpose/Description Change order 2 to increase the contract amount for owner additions, errors, <br />and omissions including paint in the parking garage stairwell, building utility <br />adjustments, mechanical equipment servicing, and addition of exterior paint. <br />km For Change Orders Only <br />Amount of ® Increase $ 201,123.20 <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 />$ 7,327,000.00 <br />Increase 2.74% <br />Decrease ( %) <br />$ 7,905,338.77 <br />Increase 7.89% <br />Decrease ( %) <br />