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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date December 9, 2016 <br />Name Jacob M. Klosinski Department Div. of Env. Services <br />BPW Date December 13, 2016 Phone Extension (574) 235-9496 <br />Required Prior to Submittal to Board <br />Legal ® Attorney Name Michael Schmidt <br />Controller ® Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing ® Carol Kurzhal <br />I uneck the Appropriate Item Type — Required for All Submissions <br />❑ Agreement ❑ Contract ❑ Proposal ❑ Addendum <br />❑ Professional Services ❑ Resolution <br />❑ Bid Opening ® Bid Award ❑ Re to Advertise <br />❑ Quote Opening ❑ Quote Award q' El Title Sheet <br />❑ Change Order No. ❑ C/O & PCA No. ❑ PCA <br />❑ Ease/Encroach. ❑ Traffic Control <br />Company or Vendor Name HRP Construction, Inc. <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of <br />J Yes Z No ❑ If Yes, Approved by Purchasing <br />] MBE ❑ WBE <br />Calvert Street Lift Station Replacement <br />116-053 <br />Wastewater Capital Improvements and Pokagon Band / Pokagon Gaming <br />Authority (refer to Memorandum for Detail) <br />GVA <br />Lump Sum (Not to Exceed, subject to final quantities for unit Drice items) <br />The Division of Utilities recommends a Bid Award of Project No. 116-053 <br />Calvert Street Lift Station Replacement to HRP Construction, Inc. as the <br />lowerst, responsive, responsible bidder. Award is provided, subject to <br />encumberance of funds from the Pokgaon Band (see Memorandum). <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion. Non-Discriminatinn Nnn-nPhnrmnnr P-vorir„ 1— -+- N <br />Increase <br />Decrease <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Copy <br />Original <br />® <br />❑ <br />® <br />❑ <br />Al Greek <br />Jacob M. Klosinski <br />Uarol Kurzhal <br />Hner <br />