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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date November 5, 2018 <br />Name Jacob M. Klosinski <br />Department Utilities - Wastewater <br />BPW Date November 13, 2018 Phone Extension �57� <br />191, XWffi�i10044 I —04"M M", J235-9496 <br />-Reqyy�qq Prior to Submittal to Bo a r d <br />Legal Z Attorney Name Clara McDaniels <br />Controller z 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 *AI Greek Director of Utilities* <br />r o riate I tem Type Required for All Submissions i <br />p ­­­ ­­­­ ­­­­ .- I <br />Agreement Check the AppMontr-act.-I., El Proposal 0 Addendum <br />F1 Professional Services F] Resolution <br />F1 Bid Opening 0 Bid Award El Req. to Advertise Z Title Sheet <br />F] Quote Opening El Quote Award <br />Z Change Order No. 1 C/O & PCA No. ❑ PCA <br />0 Ease/Encroach. ❑ Traffic Control <br />F1 Other: <br />uired Information <br />Company or Vendor Name HRP Construction Inc <br />New Vendor Ej Yes M No El If Yes, Approved by Purchasing <br />MBE/WBE Contractor F MBE [-] WBE <br />MBE/WBE Contractor Requested E] NoF] Yes Name ofCompany <br />_ <br />Wastewater Treatment Plant Headworks Influent Gate <br />Project Name Improvements <br />Project Number 117-026 <br />­­ . . ...... ..... <br />Funding Source Utilities, Wastewater Capital - ------ <br />...................... <br />Account No. 642-0630-415-43-66 <br />Amount <br />Terms of Contract <br />Purpose/Description Utilities requests BPW approval of Change Order No. 1 which <br />includes credits for adjustments in materials, reduced electrical <br />scope, and 20 additional days due to supplier related issues early in <br />the project for clate procurement. <br />Fj Required Contractor's Certification Form Attached (Non- <br />mmmCollusion, Non -Discrimination, Non -Debarment, E-Verify ,,_.Iran, etc.) <br />............... <br />equirea For Change Orders Only <br />Amount of increase - $ <br />Decrease $351,345.56 <br />Previous Amount 9-6 6,50`0.0 0­ ..................................................... <br />.... . ..... . <br />Current Percent of Change- -d6-.-356�6 <br />. . . ..... . ............ . ........ .............. <br />New Amount $ 615,154.44; Add 20 Days to Substantial & Final Completion <br />.............. <br />Total Percent of Change: -36.35% <br />Dispersal After Approval-------------- ­­­­ ...................... <br />Copy Original <br />Al Greek, Director of Utilities <br />❑ Jacob M. Klosinski, Aiil�ia­nt 'C" ... ity ...... E .... ng, i ine" ... e"r ........... . . ...... <br />Susan Zeeb, Director of Financial Services Wastewater <br />