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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Mav 12, 2017 <br />Jacob M. Klosinski <br />Purchasing ® Carol Kurzhal <br />❑ Professional Services <br />❑ Bid Opening <br />❑ Quote Opening <br />® Change Order No. 9 <br />❑ Ease/Encroach. <br />Other: <br />H Resolution <br />❑ Bid Award <br />❑ Quote Award <br />❑ C/O &PCA No. <br />❑ Traffic Control <br />Department Utilities Wastewater <br />❑ Req. to Advertise ❑ Title Sheet <br />❑ PCA <br />Company or Vendor Name Thieneman Construction, Inc. <br />New Vendor ❑ Yes ® No ❑ If Yes, Approved by Purchasing <br />MBEIWBE Contractor ❑ MBE ❑ WBE <br />MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company <br />Project Name Wastewater Treatment Plant Seconds Treatment Improvements <br />Project Number <br />114-053 <br />2011 Sewer Bond, 2012 Sewer Bond, <br />Funding Source Purchases / Treatment and Disposal <br />659-0630-415-42-06 (2011 Bond); 661 <br />Account No. Bond); 642-0630-415-43-66 <br />Amount <br />Terms of Contract <br />Lump Sum and Unit Prices <br />Wastewater Equipment <br />630-415-42-06 (2012 <br />Purpose/Description The Division of Utilities recommends the Board of Public Works <br />approval of Change Order No. 9 which reflects necessary changes <br />or additions to the scope of work see attached Inter --Office <br />Memorandum for Details). <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Amount of ® Increase $ 27,084.00 + 0 Days to Substantial & Final Completion <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 />® <br />❑ <br />$ 13,019,600.87 <br />+0.22% <br />$ 13,046,684.87 <br />+9.77% <br />Dispersal After Approval <br />Al Greek, Director of Utilities <br />Jacob M. Klosinski, Assistant City Engineer <br />Carol Kurzhal, Director of Financial Services, Environmental Services <br />