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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date December 12, 2016 <br />Name Jacob M. Klosinski Department Div. of Env. Services <br />BPW Date December 22, 2016 <br />Phone Extension (574) 235-9496 <br />Required Prior to Submittal <br />to Board <br />Legal ® <br />Attorney Name Michael Schmidt <br />Controller ® <br />Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing ® <br />Carol Kurzhal <br />Check <br />the Appropriate <br />Item Type <br />— Required <br />for All Submissions <br />❑ <br />Agreement <br />❑ <br />Contract ❑ Proposal ❑ Addendum <br />❑ <br />Professional Services <br />❑ <br />Resolution <br />❑ <br />Bid Opening <br />® <br />Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ <br />Quote Opening <br />❑ <br />Quote Award <br />❑ <br />Change Order No. <br />❑ <br />C/O & PCA No. ❑ PCA <br />❑ <br />Ease/Encroach. <br />❑ <br />Traffic Control <br />❑ <br />Other: <br />Required <br />Information <br />Company or Vendor Name <br />Thieneman Construction, Inc. <br />New Vendor <br />❑ Yes ® No ❑ If Yes, Approved by Purchasing <br />MBE/WBE Contractor <br />❑ MBE ❑ WBE <br />Project Name <br />Wastewater Treatment Plant - Digester Gas Utilization Project <br />Project Number <br />116-05OR <br />Funding Source <br />Wastewater Capital Improvements and Other Contractual Services <br />Account No. <br />642-0630-415-43-66 (Capital) and 642-0630-793-63-35 (Oth Contr Serv) <br />Amount <br />$ 754,000.00 <br />Terms of Contract <br />Lump Sum (Not to Exceed, subject to final quantities for unit price items) <br />Purpose/Description <br />The Division of Utilities recommends a Bid Award of Project No. 116- <br />050R W WTP Digester Gas Utilization Project to Thieneman Construction, <br />Inc. as the lowerst, responsive, responsible bidder. <br />❑ Required Contractor's Certification Form Attached (Non - <br />Amount of ❑ Increase <br />❑ Decrease <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy Original <br />® ❑ Al Greek <br />® ❑ Jacob M. Klosinski <br />® ❑ Carol Kurzhal <br />