HomeMy WebLinkAboutOpening of Quotes - Auten Road Water Main Replacement Proj No. 122-052 - Selge Contruction Co., Inc.BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date: 07-16-2022
Name: Jacob M. Klosinski Department of Public Works – Engineering Division
BPW Date: 07-26-2022 Phone Extension: 9496
Required Prior to Submittal to Board
BPW Attorney X Attorney Name Clara McDaniels
Dept. Attorney Attorney Name Clara McDaniels
Purchasing Michael Schmidt
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
New Vendor Yes If Yes, Approved by Purchasing
No
MBE/WBE Contractor MBE
WBE Completed E-Verify Form Attached Yes
No
Project Name Auten Road Water Main Replacement
Project Number 122-052 (PR-00018246)
Funding Source Water Works Capital
Account No. PR # 00018246 (Acct: 622-06-604-620-442010)
Amount
Terms of Contract Unit Price Quotes for 12-inch water main installation
Special Contract Provisions
Purpose/Description The Division of Engineering and Division of Utilities requests the Board of
Public Works open quotations for the subject project. Quotations are for unit
price costs for 12-inch ductile iron water main replacement. Work will be
performed along Auten Road between Laurel Road and Lindenwood Drive
East in conjunction with a St. Joseph County trail extension project.
For Change Orders Only
Amount of
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Previous Amount $
Current Percent of Change:
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New Amount $
Total Percent of Change:
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Time Extension Amount:
New Completion Date:
TRAFFIC CONTROL AND OCCUPANCY REQUEST
City of South Bend – Division of Engineering
227 W Jefferson Boulevard, Ste 1316
South Bend, IN 46601
Name of Contractor/Company:
Name of Applicant:
Phone: Email Address:
On-Site Contact: Phone:
Requested Dates (mm/dd/yyyy): _______ /_______ /20_______ to _______ /_______ /20_______
Time of Work: _____________________ to ____________________
Location of Work: Entire Street Travel Lane Parking Lane
Sidewalk Tree Lawn Alley
Type of Work: Excavation/Boring (Also requires Excavation Form)
New Drive Approach (Also requires Curb Cut Application)
Sidewalk
Address of Project:
Project Boundaries:
Description of Work:
Traffic control plan including detour map and traffic devices.
Communication (letter, door hanger, signs, etc.) to affected property owners
Failure to use traffic control for traffic restrictions or closures will result in stop w ork
orders and/or delay in permitting. This Occupancy Permit Request is non-transferable. A
signature subjects the named contractor/permittee to all applicable rules, duties and
obligations imposed by the South Bend Municipal Code and to all regulations imposed by
the City’s Board of Public Works.
Signature of Applicant: Date:
Applications should be dropped off to the City’s Engineering Office or emailed to
rowpermitsoffice@southbendin.gov. For questions, contact Liz Horvath at 574.235.9254.
DEADLINE: DUE FIVE BUSINESS DAYS PRIOR TO PROJECT START DATE
PROJECT INFORMATION
OFFICE USE ONLY:
Date Received: Fee Paid: Approval Date:
INCLUDE THE FOLLOWING ITEMS WITH YOUR APPLICATION:
APPLICANT INFORMATION
Auten Road Water Main Replacement12-inch ductile iron water main betweenLaurel Road and Lindenwood Drive East.Water main under Auten Road carries in a20-inch steel casing. Refer to RecordDrawings for general location and profile