HomeMy WebLinkAboutResolution No 47-2022 - SRF Loan Program Signatory AuthorizationBOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date: 10-03-2022
Name: Jacob M. Klosinski Department of Public Works – Engineering Division
BPW Date: 10-11-2022 Phone Extension: 9496
Required Prior to Submittal to Board BPW Attorney X Attorney Name Michael Schmidt
Dept. Attorney Attorney Name Michael Schmidt
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
Resolution naming Signatory for State Revolving Fund correspondence for
Project No. 119-069B WWTP Final Clarifiers 1, 2, and 3 Rehabilitation
(See attached)
Project Number 119-069B (PROJ00000367)
Funding Source
Account No.
Amount
Terms of Contract
Special Contract Provisions
Purpose/Description Public Works, Engineering, and Utilities requests the Board of Public Works
adopt a Resolution to name Eric C. Horvath the Signatory for correspondence
with the State Revolving Fund office for application and information requests
as they relate to potential funding opportunities for Project No. 119-069B
WWTP Final Clarifiers 1, 2, and 3 Rehabilitation. The adoption of a the
Signatory Resolution is a requirement of the State Revolving Fund program.
For Change Orders Only
Amount of
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Decrease
$
($ )
Previous Amount $
Current Percent of Change:
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%
( %)
New Amount $
Total Percent of Change:
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