HomeMy WebLinkAboutRequest to Advertise & Title Sheet - Prairie Ave. Water Main Loop Proj No. 117-068BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 9/17/2021
Name Sue Ellen Doudrick Department Engineering
BPW Date 10/12/2021 Phone Extension 5922
Review and Approval Required Prior to Submittal to Board
Diversity Compliance
and Inclusion Officer Officer Name
BPW Attorney Attorney Name
Dept. Attorney Attorney Name
Purchasing
Check the Appropriate Item Type – Required for All Submissions
Professional Services Agreement Contract Proposal
Open Market Contract Amendment/Addendum Special Purchase, QPA
Bid Opening Bid Award Req. to Advertise Title Sheet
Quote Opening Quote Award Reject Bids/Quotes
Proposal Opening C/O & PCA No. PCA
Chg. Order, No. Traffic Control Resolution
Other: Ease./Encroach
Required Information
Company or Vendor Name TBD
New Vendor Yes If Yes, Approved by Purchasing
No
MBE/WBE Contractor MBE
WBE Completed E-Verify Form Attached Yes
No
Project Name Prairie Avenue Water Main Loop
Project Number 117-068
Funding Source PROJ00000069 – SSTIF & Water Works Capital
Account No. Fund 430 & Fund 622 (PR-00012245)
Amount TBD
Terms of Contract Unit Prices
Purpose/Description Water Main Loop along Prairie Avenue from US 20 going west to a location
north of Ireland Ridge Ct.
For Change Orders Only
Amount of Increase
Decrease
$
($ )
Previous Amount $
Current Percent of Change:
Increase
Decrease
%
( %)
New Amount $
Total Percent of Change:
Increase
Decrease
%
( %)
Time Extension Amount:
New Completion Date: October 12, 2021
9/22/2021
October 12, 2021