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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 06/04/18 Department Public Works <br />Name Amy Kryston Division/Bureau Engineering <br />BPW Date 06/26/18 Phone Extension, 9246 <br />Required Prior to Submittal to Board <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 />Check the Appropriate Item Type - Required for All Submissions <br />F-1 Agreement Amendment F-1 contract El Proposal ❑ Addendum <br />Z Professional Services F-1 Resolution <br />F-1 Bid Opening El Bid Award E] Req. to Advertise El Title Sheet <br />[:] Quote Opening F-1 Quote Award <br />F] Change Order No. n C/O & PCA No.. RCA <br />❑I Ease/Encroach. F-1 Traffic Control: <br />F-1 Other: <br />Required Information <br />Company or Vendor Name Gregory A Kil & Associates, Inc. <br />El Yes 0 No El If Yes, Approved by <br />New Vendor Purchasinq <br />MBE/' VBE Contractor <br />MBEANB,E Contractor Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />LJ MBE LJ WBE <br />0 No El Yes Name of Company <br />324-1050-460-42.02 <br />$32,700.00 <br />Engineer shall submit its invoices to <br />Owner on a monthly basis. Invoices are due and payable within <br />35 days of receipt. The portion of the compensation amount <br />billed monthily for Engineer's services will be based upon <br />Engineer's estimate of the percentage of the total services <br />actually completed during the billing period. <br />Approve the contract (EJCDC) between the City of South Bend <br />and KH & Associated for the Limited Scope Architectural and <br />Engilineering Consultation for repair or replacement of the <br />skylight and masonry repair/tuck pointing for the Lafayette <br />Building at 115 South, Lafayette Street, South Bend, IN <br />F1 Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />�Roquired For C hande Orders Only <br />Amount of ❑ <br />increase $ <br />❑Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />