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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 6/05/18 <br />Name Roger Nawrot <br />Department <br />Division/Bureau <br />Public Works <br />Engineering <br />BPW Date 6/12/18 Phone Extension 5932 <br />H Agreement Ll Contract L] Proposal Ll Addendum <br />® Professional Services ❑ Resolution <br />❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening ❑ Quote Award <br />❑ Change Order No. ❑ CIO & PCA No. ❑ PCA <br />❑ Ease/Encroach. ❑ Traffic Control: <br />6a Other: Amendment No. 2 <br />Company or Vendor Name <br />DLZ Indiana, LLC <br />❑ Yes ® No ❑ If Yes, Approved by <br />New Vendor <br />Purchasing <br />MBEANBE Contractor <br />❑ MBE ❑ WBE <br />MBE/WBE Contractor Requested <br />❑ No ❑ Yes Name of Company <br />Project Name <br />Colfax Avenue Two -Way Conversion <br />Project Number <br />115-053 <br />Funding Source <br />West Washington Development Area T1F <br />Account No. <br />422.1050.460.42.03 <br />Amount <br />$234,150.00 (Previously $214,500.00, Increase of 19,650.00) <br />Terms of Contract <br />Adjustments to ROW Services, Split the project into two <br />Purpose/Description <br />contracts for bidding with the second contract bid in 2019, <br />redesign of the West Colfax Alley approach and preparation of <br />riaht-of Wav Dedication Plat. <br />U 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 />