HomeMy WebLinkAboutTraffic Control Device - Stop Sign - Lakewood DriveBOARD OF PUBLIC WORKS
Request for Approval of
Traffic Control Device(s)
Date: February 28, 2017
I hereby submit the following installation or change of traffic control devices for review:
Traffic Request Number: TR16-118
® New Installation
❑ Removal
❑ Revision
® Stop Sign
❑ Stop Sign
❑ Stop Sign
❑ Yield Sign
❑Yield Sign
❑ Yield Sign
❑ Speed Limit, _mph
❑ Speed Limit, mph
❑ Speed Limit, _mph
❑ Other, List
❑ Other, List
❑ Other, List
Location(s): Lakewood Drive at intersection with Brockton Drive (see attached drawing)
This has been submitted:
® In response to request by a citizen/ neighbor/ passerby: Anonymous 311 Caller
❑ In response to contracted reconstruction or improvements
❑ In response to developer -provided reconstruction or improvement
❑ In response to an internally -generated concern from
Remarks: 3-wav intersection of a residential neiehborhood streets
Submi d ropose y:
oge . Nawrot, PE, LS
Assistant City Engine r
Date: Z7/57 /'�
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APPROVED: SOUTH BEND BOARD OF PUBLIC
WORKS
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Gary A. Gilot, President
Suzanna M. Fritzberg, Member
James A. Mueller, Me
e her
Elizabeth A. Maradik, Member
Therese J. Doran, Me ber
Distribution:
Bureau of Traffic and Lighting
South Bend Police Department Traffic Division
Recommend Approval/Denial:
Attest:
—lip
da M. Martin, Clerk
Date
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BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date March 7, 2017
Name Roger Nawrot
Department
Division/Bureau
Public Works
Engineering
BPW Date March 14, 2017 Phone Extension 5933
Legal ❑ Attorney Name:
Controller El greater
review is required for all Contracts $5,000.00 or more and
greater than one year in length per the City Purchasing Policy
Purchasing ❑
Check the Appropriate Item Type — Required for All Submissions
❑ Agreement ❑ Contract ❑ Proposal ❑ Addendum
❑ Professional Services ❑ Resolution
❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet
❑ Quote Opening ❑ Quote Award
❑ Change Order No. ❑ C/O & PCA No. ❑ PCA
❑ Ease/Encroach. ® Traffic Control:
❑ Other:
Reauired Information
Company or Vendor Name
New Vendor
MBE/WBE Contractor
MBE/WBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
❑ —Yes® No ❑ If Yes, Approved by
Purchasinq
❑ MBE ❑ WBE
❑ No ❑ Yes Name of Company
Lakewood Dr &
f�
Terms of Contract
Purpose/Description
❑ Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
Required For Change Orders Only
Amount of ❑ Increase $
❑
Decrease $
Previous Amount
Current Percent of Change:
New Amount
Total Percent of Chanae:
Copy
Original
®
❑
®
❑
Dispersal After Approval
Assistant
Ed Gleckler, Manager Bureau of Traffic & Lighting
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