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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />15.2018 <br />Jacob M. Klosinski <br />Department Utilities Wastewater <br />BPW Date May 22, 2018 Phone Extension (574) 235-9496 <br />Required Prior to Submittal to Board <br />Legal ® Attorney Name Clara McDaniels <br />Controller ® Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing <br />® *AI Greek Director of Utilities* <br />H Agreement LJ Contract Ll Proposal Addendum <br />❑ Professional Services ❑ Resolution <br />❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening ❑ Quote Award <br />® Change Order No. 19 ❑ CIO & PCA No. ❑ PCA <br />❑ Ease/Encroach. ❑ Traffic Control <br />n Other: <br />Company or Vendor Name Thieneman Construction Inc. <br />New Vendor ❑ Yes ® No ❑ If Yes, Approved by Purchasing <br />MBEIWBE Contractor ❑ MBE ❑ WBE <br />MBEIWBE Contractor Requested ❑ No ❑ Yes Name of Company <br />Project Name Wastewater Treatment Plant Secondary Treatment Improvements <br />Project Number 114--053 <br />Funding Source <br />2018 Wastewater Capital Account <br />Account No. <br />642-0630-415-43-66 <br />Amount <br />$ <br />Terms of Contract <br />Lump Sum and Unit Prices <br />Purpose/Description <br />The Division of Utilities recommends the approval of Change Order <br />No. 19 which includes additions and deletions to the scope of work <br />as described in the attached Inter -Office Memordandum and <br />Change Order Documents. <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc. <br />Requre;d <br />ForChange Orders Only <br />Amount of ❑ <br />Increase $ <br />® <br />Decrease $ 10,492.00 <br />Previous Amount <br />$ 13,897,089.91 <br />Current Percent of Change: -0.09% <br />New Amount $ 13,886,597.91 <br />Total Percent of Change: +16.84% <br />Dispersal After Approval <br />Copy Original <br />® ❑ Al Greek, Director of Utilities <br />® ❑ Jacob M. Klosinski, Assistant City Engineer <br />0 0 Director of Financial Services, Environmental Services <br />