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HomeMy WebLinkAboutAward Quote - 2023 Contracted Microsurfacing Proj No. 123-023 - National Pavement Maintenance1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 PHONE 574/235-9251 FAx 574/235-9171 CITY OF SOUTH BEND JAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS July 25, 2023 Mr. Gary Newman National Pavement Maintenance 1928 N. Campbell Ave. Indianapolis, IN 46218 gnewman 12345kgmail.com RE: Quotation Award — 2023 Contracted Microsurfacing — Project No. 123-023 Dear Mr. Gary Newman: At its July 25, 2023 meeting, the Board of Public Works awarded the above referenced quotation to you in the amount of $97,960; Base Quote. Please forward the following documents in one submittal by August 8, 2023 to my attention for Board of Public Works approval at lhensley&southbendin.gov : 1) One (1) signed original of the Contract (enclosed); and 2) Certificate of Insurance naming the City of South Bend as an additional insured. If you have any further questions, please call this office at (574) 235-9251. Sincerely, Is/ Theresa Heffner Theresa Heffner, Clerk Enclosures TH/lh ELIZABETH A. MARADIK JOSEPH R. MOLNAR GARY A. GILOT JORDAN V. GATHERS MURRAY L. MILLER 1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 PHONE 574/235-9251 FAx 574/235-9171 CITY OF SOUTH BEND JAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS July 25, 23023 Mr. Jamie Brown Asphalt Restoration Services, LLC PO Box 2484 South Bend, IN 46680 andrea.brown2kcomcast.net RE: Quotation Award — 2023 Contracted Microsurfacing — Project No. 123-023 Dear Mr. Brown: At its July 25, 2023 meeting, the Board of Public Works awarded the above referenced quotation to National Pavement Maintenance in the amount of $97,960; Base Quote. We thank you for quoting and hope you will quote with us again in the future. If you have any further questions, please call this office at (574) 235-9251. Sincerely, /s/ Theresa Heffner Theresa Heffner, Clerk Enclosures TH/lh ELIZABETH A. MARADIK JOSEPH R. MOLNAR GARY A. GILOT JORDAN V. GATHERS MURRAY L. MILLER INTER -OFFICE MEMORANDUM DEPARTMENT OF PUBLIC WORKS DIVISION OF ENGINEERING TO: Theresa Heffner, Clerk Board of Public Works FROM: Scott Kreeger Project Engineer, Division of Engineering SUBJECT: Award: 123-023 2023 Microsurfacing Quote DATE: July 12, 2023 On July 11, 2023, the Board of Public Works opened and read quotes for the above project. The Division of Engineering has reviewed the submitted documents and listed the quoters as follows: Quote Quote Amount 1. National Pavement Maintenance $97,960 2. Asphalt Restoration Services, LLC $118,000 This project has been deemed non -goal eligible with respect to MWBE subcontracting following review by the Office of Diversity and Inclusion, the Legal Department, and Engineering. The project cannot reasonably be subdivided as required by the Minority and Women Business Enterprise Inclusion Program Plan §8.B.2: §8.B.2 Non -Goal -Eligible Contracts If a contract is not goal -eligible, either because it is not able to be subdivided into commercially useful functions or because it does not contain any work described in the NAICS Codes in Attachment A, the Program Administrator will not set goals for that contract. For this project, the crews are small and are performing only one task (roadway microsurfacing). There are no specialized sub -tasks like electrical or planting work that can be separated out as commercially useful functions. Engineering recommends award of the base quote to the lowest responsive and responsible bidder, National Pavement Maintenance, in the amount of $97,960. The Department of Public Works has appropriated sufficient funds from the Economic Development fund (Funding #408-06-602-503-436008; PR-26138) Please respond with any questions (EXT 9245). Enc. Bid Tabulation QUOTE TABULATION 123-023 2023 Microsurfacing BASE QUOTE Engineer's Estimate National Pavement Maintenance Asphalt Restoration Services, LLC Item No. Line Item Quantity Unit Unit Price Cost Unit Price Cost Unit Price Cost 1 ASPHALT MICROSURFACING 16,840 SYD $5.30 $89,252.00 $5.817 $97,958.28 $7.01 $118,000.00 Total Base Quotel $89,252.00 $97,960* $118,000.00 *Note: National Pavement Maintenance unit price number does not match the final contract amount. Non -Collusion Affadavit Y Y I hereby certify that the above truly and accurately represents bids received for this project on July 11, 2023 Scott Kreeger, Project Engineer 5:\Public Works\Projects\Projects by Year\2023 Projects\123-023 2023 Microsurfacing Quote\1- Admin\1- BPW Documents\123-023 Quote Tabulation t CITY OF SOUTH BEND, INDIANA r CONTRACTOR'S QUOTE FR PUBLIC WORK PROJECT NAME: 2023 Microsurfacin PROJECT NO. 123-023 QUOTES IDUE July 11th, 2023 at 9:00am Local Time. Quotes are to be submitted electronically to b wb idsC<Dsouthbendin. gov (Must be completed for all quotes. Please type or print) Date: 71e 1 3 Firm: flir�,T[ U rg a-1'�V� C tA- U, Address: -1 F t4 C� n�' �G� r k:I City/State/Zip: t4 Telephone Number: ( �17 - r7 Agent of Bidder (if Applicable): Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the public works project of: 2023 Microsurfacina the City of South Bend, Indiana, in accordance with plans and specifications prepared by: The City of South Blend, Department of Public Works and dated -7 for the sum of (enter the Total Quote as shown on the Proposal) (Enter Sum of Total Quote shown on Proposa ` ' (Numerical) If alternative quotes apply, the undersigned submits a proposal for each in accordance with the notice. Any addendums attached will be specifically referenced at the applicable page. If additional units of material included in the contract are needed, the cost of units must be the same as that shown in the original contract if accepted by the City of South Bend. If the quote is to be awarded on a unit basis, the itemization of the units shall be shown on a separate attachment. By (Signature) (Printed Name of Person Signing) ACCEPTANCE The above quote is accepted this day of 20 Subject to the following conditions: CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Joseph R. Molnar, Vice President Gary A. Gilot, Member Jordan V. Gathers, Member Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk Date: July 25, 2023 BOARD OF PUBLIC WORKS CITY OF SOUTH BEND, INDIANA PUBLIC WORKS CONTRACT This Agreement is made and entered into this 25th Day of July, 2023, by and between National Pavement Maintenance, (the "Contractor"), and the Board of Public Works (the 'Board"). The Contractor covenants and agrees to make the following improvement, as fully set out in the Request for Quotations, Standard Specifications, Special Provisions, Plans, and Bid Proposals, all of which are set forth as a part of this Contract, for: PROJECT NO. 123-023 DESCRIPTION: 2023 CONTRACTED MICROSURFACING COMPLETION DATE: SEE SPECIFICATIONS AMOUNT: $97,960; BASE QUOTE FUNDING: PR-0002613 8 The unit prices for this improvement were those prices as received and accepted by the Board on the 1 lth Day of July, 2023. The Contractor further agrees to notify the assigned Engineer when this improvement is completed. This notification shall be in the form of a Project Completion Affidavit, signed by the Contractor. Upon final acceptance of the improvement by the Engineer, the Contractor's final estimate will be presented to the Board for final Payment with one (1) copy of the Project Completion Affidavit and one (1) copy of a Waiver of Lien. Each of the Parties, by signing below, represents and warrants to the other Party that he/she/it has the authority to bind the named person or entity to this Agreement. CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS e� Elizabeth A. Maradik, President Mom— _s,ri Gary A. Gilot, Member Murray L. Miller, Member Joseph R. Molnar, Vice President Jordan 1�>�V. Gathers, Member Attest: Theresa M. Heffner, Clerk Date: July 25, 2023 NATIONAL PAVEMENT MAINTENANCE Printed Name Signature CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MWBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS I affirm that I have made good faith efforts to assist interested MWBEs in obtaining necessary equipment, supplies, materials, or related assistances or services, where U appropriate. I affirm that I did not reject any MWBEs as unqualified without sound business reasons based on a thorough investigation of their capabilities. CONTRACT RECORDS: The bidder has maintained the following records for each MWBE that has bid on the subcontracting opportunity: 1. Name, address, and telephone number, 2. A description of information provided by the bidder or subcontractor, and 3. A statement of whether an agreement was reached, and if not, why not, including any reasons for concluding that the MWBE was unqualified to perform the job. 'Proper demonstration of Good Faith Efforts requires your initials next to all of the above boxes. Any omissions shall be considered grounds for rejection of the bid by the Board of Public Works. The City of South Bend reserves the right to request additional information. Version 2/14/2022 Page- 18 Public Works Quote QUOTE/PROPOSAL CITY OF SOUTH BEND PROJECT NAME 2023 Microsurfacing PROJECT NO. 123-023 July 11th, 2023 at 9:00am Local Time. Quotes are to be QUOTES DUE submitted electronlcally to bowbids(@southbendin.aov Bid Quote Item No. Description Quantity Unit I Unit Price I Total Amount 1 ASPHALT M)CROSURFACING 1e,840 1 SYD I S.5 (7 sq 7, quo Firm: Address: City/State/Zip: �UE Vi \ Kk-eFt ms g 60,w,gp,�t{ Ave- 9 TelephoneNumbw: (3(7) �yo'S2Jg0 I$ Fax Number: By (signature) F"s62a KEPtN (Printeald Name of Person Signing) Version 2/14/2022 Page- 15 Public Works Quote CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MWBE-2.1 MWBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact MW BEs. It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the MWBE qualifications. Attach additional pages if necessary. PAGE / OF 2- Project Number: 123-023 MWBE Participation Goal N/A Project Name: 2023 Microsurff acing Bidder: /VATtdkrke PAti5MEuT VAWAki-N-ANcE By: V-"W AEi // 23 (Signat re (Title) (Date) MWBE Finn Sf1.1:�LL ell& 9 /.pCFT' do Owner or Contact at MWBE Firm 'I fei v�s„G9 Telephone: 5Xq-`/OD-O(19ry- Fax Email: eeiig �Er.I£CL-Cdla'FR,q�,ub,4Ati TYPE OF WORK SOLICITED FOR THIS PROJECT: Q1AerLl,&4-r o sla5 ��s1a (3A2Q1 [.AcQ.fS RESULTS OF CONTACT WITH THE MWBE FIRM: /15)Ceeet & uSE 41ts F,Rw MWBE Firm S/q�f (3A2QICr>Q/Ka Owner or Contact at MWBE Firm-SfykES rNl c(�r°i5kl Telephone: 5-7 4 - JZ7 -;s78 Fax: Email: �A LtiCS M, chp(SKr !I 5MA,,t, a dl TYPE OF WORK SOLICITED FOR THIS PROJECT: /��1 2f^-tat v-P if�1j (,Iuj VACe C-y,,5 RESULTS OF CONTACT WITH THE MWBE FIRM: 40-tfd iJ uSt i'GS Flee-- Version 2/14/2022 Page - 19 Public Works Quota CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MWBE-2.1 MWBE CONTACTED This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring Good Faith Efforts to contact MWSEs. It is the bidders sole responsibility to verify whether any listed minority or woman business meets the MWBE qualifications. Attach additional pages if necessary. PAGE d- OF Z Project Number: 12M23 MWBE Participation Goal N/A Project Name: 2023 Microsurfacing Bidder: t4abofikL PAVE"kn T" (M06.If4+eA( NCf. By: i`�✓"`M a --I"- W /r, 4z3 (Sgns[ure) (Title) (Dale) (r MWBE Firm Le A(Ck A. f414n (.[C Owner or Contact at MWBE Firm LAt~UaL ((CWWt1 ,u Telephone: _7JQ PIS I -S I LI5 Fax: Email: -2 TYPE OF WORK SOLICITED FOR THIS PROJECT: U-Eu r"AN ®S-wo t L c ifl-ate d TPUCKIyi W4U'fR4 RESULTS OF CONTACT WITH THE MWBE FIRM:� ro2yh ryvt5 6Y%T i'u Sf S� rzufr USfO fN -f" �n44E�1 1 fGr it�tLea -TA4e E(2 rfc? �bk 5(i JSE -fL.iS p', 0. MWBE Firm Owner or Contact at MWBE Firm Telephone: Fax: TYPE OF WORK SOLICITED FOR THIS PROJECT: Email: RESULTS OF CONTACT WITH THE MWBE FIRM: Version 2/14/2022 Page - 19 Public Works Quote CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MWBE-2.0 EVIDENCE OF GOOD FAITH EFFORTS This completed form should be Included as part of the Bids documents related to City of South Bend Public Works Projects requiring Good Faith Efforts to obtain MWBE participation. Project Number: 123-023 Date: -7/ f f /L 3 Project Name: 2023 Mleroaurtacing Bidder: NaYloNr4L RAVE►ttMT Contact Person: inA224 ALFWWtIo%ru Telephone: 3!7 /Z$O—.ifi300 Address: PUS N eAfv?0ELC A V-r- City: -WoljVvaPO/. State: !N zip: Email: 5 ar•.,a wPfx, us.cu— To determine whether a bidder has demonstrated good faith efforts to reach the MWBE utilization goals set forth in the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or commissions, REQUIRE ALL of the fallowing Good Faith Efforts as listed in the table below: INITIALS EVIDENCE OF GOOD FAITH EFFORTS MWBE LIST(S): The bidder reviewed 1) the City of South Bend's Minority and Women Business Enterprise Inclusion Program Plan; 2) the list of certified MWBEs provided by the City; and 3) the Indiana Department of Administration list of Minority and Women Owned Businesses (both certified and non- carti0ed) found at: htl ://v .in. v/idoa/. GOOD FAITH EFFORTS TO OBTAIN MWBE PARTICIPATION The bidder shall initial each item below, as evidence of Its good faith efforts to obtain MWBE participation in the awarded contract. I affirm that I reviewed the City of South Bend's Minority and Woman Business Enterprise Inclusion Program Plan and the Indiana Department of Administration's certified list of Indiana Minority and Women Business Enterprises, found on [heir webske (hftp;i/www.in.gov/idoa). I affirm that I have made good faith efforts to select portions of the contract wok to be [AV-� performed by MWBEs, including, where appropriate, breaking out contract work items Into U economically, feasible units to facilitate MWBE participation. nY 1 affirm that I have made good faith efforts to solicit through all reasonable and available -U- means the interest of all MWBEs in the scopes of work of the contract. I affirm that I attended all pre -bid meetings scheduled by the City of South Bend to inform MWBEs of connecting and subcontracting opportunities. I affirm that I advertised in general circulation and/or trade association publications .LNG- conceming subcontract opportunities and allowed MWBEs reasonable time to respond to ii such advertisements. I affirm that I performed any and all necessary steps to provide written notices in a manner iAf-- reasonably calculated to inform MWBEs of subcontracting opportunities and allowed !/ sufficient lime for MWBEs to participate effectively. I affirm that I followed up on initial solicitations with interested MWBEs. I affirm that negotiated with interested MWBEs in good faith, including providing such MWBEs with adequate information about the plans, speck rtions and other requirements U of the subcontract. I affirm that I have made good faith efforts to assist interested MWBEs in obtaining yy-- bonding, lines of credit, or insurance as required by the City or the bidder, where ll appropriate. Version 2/14F2022 Page- 17 Public Works Ducts CITY OF SOUTH BEND MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM MWBE-1.0 MWBE UTILIZATION PLAN Is the bidder's sole responsibility to verify whether any listed minority or woman business meets the Project Number: Bidder: 123-023 i�� wcProject Name: 2023 Mlcrosurfacing rlAtihr aiN i UtKT Ml4ff'fyKAh,?,tal Bid Amount: MWBE Goal: N/A Page i of Name aAtltlreas ofMWBE Primary Contact Person (Namerrelsphone) Scope of Work to be PerknneE (Atmch sceoVacheduleN you need additional space) Dollar Amount of MWBE Component Pementape of olel BiNPre al gaf 0r\42( rck $(w� hwt5 {MiCAC r }N( a ��5 87 U ayUdES Avew3 JS)c WEST 1574-7.87-}cr8 NIA tio,t+it154wo rc y<(pbAB -S(Wd— (C P£R� W1P5Jr '�)iu�µ5 AA0 (3AW&C0`JE7 TC43 5CAi+. 5410 Aae SZy.rf(D-`i R'F �E(KfNI PRfPeaaw¢r? /y/A "t 7"S6 -({.w3'7 Submitted by: &WW1fAN /chwNM VZLkAANCX" _%//'12-3 Pdnt Name Signature I Datei Version 2/14/2022 Page -16 Public Works Quote alien. Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify Program is included and attached as part of this bid/quote; and S. Contractor shall require his/her/its subcontractors performing work under this public contract to certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the subcontractor subsequently leams is an unauthorized alien, and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees to maintain this certification throughout the term of the contract with the City of South Bend, and understands that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision no later than thirty (30) days after being notified by the City. 6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by the City of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions, or privileges of employment, or any matter directly or indirectly related to employment because of race, sex, religion, color, national origin, ancestry, age, gender expression, gender identity, sexual orientation or disability that does not affect that person's ability to perform the work. In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any combination of the foregoing including, but not limited to, public works contracts awarded under public bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards, or commissions may consider the Contractor's good faith efforts to obtain participation by those Contractors certified by the State of Indiana as a Minority Business ("MBE's or as a Women's Business Enterprise ("WBE") as a factor in determining the lowest, responsible, responsive bidder. In no event shall persons or entities seeking the award of a City contract be required to award a subcontract to an MBE/WBE; however, it may not unlawfully discriminate against said WBE/MBE. A finding of a discriminatory practice by the City's MBE/WBE Utilization Board shall prohibit that person or entity from being awarded a City contract for a period of one (I) year from the date of such determination, and such determination may also be grounds for terminating the contact for which the discriminatory practice or noncompliance pertains. 7. The undersigned contractor agrees that the following nondiscrimination commitment shall be made a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its agencies, boards or commissions. Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the performance of this contract with privileges of employment, or any matter directly or indirectly related to employment, because of race, religion, color, sex, gender expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of contract. I, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16- 8-1). I hereby certify that I and all subcontractors employed by me for this project will use steel Version 2/142022 Page - 13 Public Works Quote products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder may result in forfeiture of contractual payments. I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this %� � day of 3uLN . 20 73 IqA-� �( I&At hAV£w+ErrI VMdK6A1A-M Contractor/Bidder (Firm) %'�.c`."�l �'1�P-EnM.�s-tom Signature of C tracmrBidder or Its Agent !A-eiz.-1 i`[LcJluyltF ;L4-e L6W- Printed Name and Title Subscribed and sworn to before me this .l{ L daay, of , 20Z My Commission Expires %"d-/-,,q) y�.(/�A Al k& - Notary Public ✓/ County of Residence An'-,(CKl SUSANNA IBABRA Notary Public - Seal Marion County - Stale of Indiana Commission Number NP0744043 My CororrdWan EePOes 5-1 r9. 2010 Version 2/142022 Page - 14 Public Works Quote When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation ro this AjTAavit CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NON-DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS (Must be completed for all quotes and bids. Please type or print) STATE OF LflC�i Ctl1Gt ) SS: C(.�I COUNTY ) The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: 1. Contractor has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding. Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and 2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency; and 3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment activities in Ivan. a. For purposes of this Certification, "Iran" means the government of Iran and any agency or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from time -to -time. b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is engaged in investment activities in Iran if either: i. Contractor, its successor or its affiliate, provides goods or services of twenty million dollars ($20,000,000) or more in value in the energy sector of Iran; or ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty million dollars ($20,000,000) or more in credit to another person for forty-five (45) days or more, if that person will (i) use the credit to provides goods and services in the energy sector in Iran; and (if) at the time the financial institution extends credit, is a person identified on list published by the Indiana Department of Administration. 4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Contractor subsequently learns is an unauthorized Version 2/14/2022 Page - 12 Public Works Quote BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 6/28/2023 Department Public Name Scott BPW Date 7/11/2023 Phone Extension 9245 Required Prior to Submittal to Board BPW Attorney ® Attorney Name Michael Schmidt Dept. Attorney ❑ Attorney Name Purchasing ❑ Mickey Low 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 Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description Information ❑ Yes ❑ If Yes, Approved by Purchasing ❑ No E] MBE ❑ WBE Completed E-Verify Form Attached ❑❑ Nos 2023 Microsurfacing Quote 123-023 Local Income Tax 408-06-602-503-43 6008 For Change Orders Only Amount of ❑ Increase $ ❑ Decrease ($ ) Previous Amount Current Percent of Change: New Amount Increase Decrease Increase Total Percent of Change: Decrease Time Extension Amount: New Completion Date: BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 7/12/2023 Department Public Name Scott BPW Date 7/25/2023 Phone Extension 9245 Required Prior to Submittal to Board BPW Attorney ® Attorney Name Michael Schmidt Dept. Attorney ❑ Attorney Name Purchasing ❑ Mickey Low 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 Information Company or Vendor Name National Pavement Maintenance New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description Yes❑ If Yes, Approved by Purchasing No El ❑ WBE Completed E-Verify Form Attached ❑❑ Yes No 2023 Microsurfacing Quote 123-023 Economic Development 408-06-602-503-436008 $97,960 Base Quote Iff For Change Orders Only Amount of ❑ Increase $ ❑ Decrease ($ ) Previous Amount Current Percent of Change: New Amount Increase Decrease Increase Total Percent of Change: Decrease Time Extension Amount: New Completion Date: