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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />ril 30. 2018 <br />Jacob M. Klosinski <br />Department Utilities Env. Serv. <br />BPW Date May 8, 2018 Phone Extension (574) 235-9496 <br />PitSdroomoRequireard <br />Legal Attorney Name Clara McDaniels <br />Controller ® Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing <br />® *AI Greek, Director of Utilities* <br />❑ Agreement <br />H Contract U Proposal Ll Addendum <br />❑ Professional Services <br />❑ Resolution <br />❑ Bid Opening <br />® Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening <br />❑ Quote Award <br />❑ <br />Change Order No. <br />❑ <br />CIO & PCA No. ❑ PCA <br />❑ <br />Ease/Encroach. <br />❑ <br />Traffic Control <br />n Other: <br />Company or Vendor Name Alfa Laval (Houston, Texas) <br />New Vendor ❑ Yes ® No ❑ If Yes, Approved by Purchasing <br />MBEIWBE Contractor ❑ MBE ❑ WBE <br />MBEIWBE Contractor Requested ❑ No ® Yes Name of Company See Contractor Bid <br />Project Name WWTP - Belt Filter Press #1 Rehabilitation <br />Project Number 118-019 <br />Funding Source Utilities - Wastewater - Other Equipment <br />Account No. 641-0630-793-36-05 <br />Amount <br />Terms of Contract <br />$ 203,131.00 (Includes $5,000 Allowance) <br />Not to Exceed. Unused Allowances shall be credited at Closeout <br />Purpose/Description Request to award Project No. 118-019 WWTP Belt Filter Press #1 <br />Rehabilitation to Alfa Laval as the most responsive, responsible <br />bidder. Contractor plans to use MBEIWBE for freight. <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion. Non -Discrimination. Non -Debarment, E-Verifv, Iran, etc.) <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, Director of Utilities <br />® ❑ Jacob M. Klosinski, Assistant City Engineer <br />® ❑ Emily Leyes, Director of Financial Services, Environmental Services <br />