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BOAIW OF PUBLIC WORI(S <br />AGENDA ITEM REVIEW REQUEST FO11 Vi <br />Date 06/04/18 Department Public Works <br />Name Amy Kryston Division/Bureau Engineering <br />BPW Date 06/12/18 Phone Extension 9246 <br />Legal Z 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 z <br />Professional Services <br />Bid Opening <br />Resolution <br />0 Bid Award <br />❑ Req. to Advertise <br />❑ Quote Opening ❑ Quote Award <br />Change Order No. _ ❑ C/O & PCA No. ❑ PCA <br />Ease/Encroach. <br />Other: <br />Company or Vendor Name <br />❑ Traffic Control: <br />New Vendor <br />MBE/WBE Contractor <br />MBE/WBE Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Danch, Harper, & Associates <br />El Yes ® No ❑ If Yes, Approved by <br />Purchasina <br />U MBE ❑'WBE <br />I-1 No n Yes Name of Company <br />Old Clay Sewer Easement A uisition <br />117-087 <br />Utility Expense/Contractual Service Fund <br />641-0621-792.63-35 <br />Title Sheet <br />$3,120.00 <br />Engineer shall submit its invoices to <br />Owner on a monthly basis. Invoices are due and payable within <br />35 da s of recei t. <br />Purpose/Description Approve the contract (EJCDC) between the City of South Bend <br />and DHA for the design and repair of six drainage issues. <br />F] Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Amount of ❑ Increase $ <br />❑ Decrease $ <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />$ <br />�fo <br />Total Percent of Change: <br />% <br />Dispersal After Approval <br />Copy <br />Original <br />❑ <br />Kara Boyles <br />❑ <br />Sue Ellen Doudrick <br />® <br />[�] <br />Amy Kryston <br />