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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />November 19. 2018 <br />Jacob M. Klosinski <br />Department Utilities Wastewater <br />BPW Date November 27, 2018 Phone Extension (574)" 235 9496 <br />i6MMYIP.2Ul'a"J�I "WWY�d' WMY91it�kP�"!Y'dWWWWW'�NM'i�'F'YdYb4�'ri��Yl Vl�.ild,�:. ._. ✓Ptak'. ':',�WWVWWIIIW dV+�Y�,�Y�Du�y!NFIY. � w+mmnvnr�— �my�„.. IVfY1(W�NVi3 v �iui�Pr9�oPi�,� �. ��1F�IWIMrtrvil' mmrwam �a�..m.:ft'L�NINININIIIIIII II����N':M�YW."A'ek bEr^uJ,✓�iYiN „kuVX <br />Required_ "'_ ... ....... , ._ .....� ._ ti ..e...._ <br />Prior to Submittal to Board <br />Legal ® <br />Attorney Name Clara McDaniels <br />Controller ® <br />Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing ® <br />*AI Greek Director of Utilities* <br />..m.......... ... _. _ _���_ ��_ .__ .... _ --- <br />Check the Appropriate Item Type — Required for All <br />❑ Agreement <br />❑ <br />_Submissions <br />Contract Proposal Addendum���� <br />El <br />Professional Services <br />Resolution <br />Bid Opening <br />El <br />Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />Quote Opening <br />❑ Quote Award <br />Change Order No. <br />® C/O & PCA No. 20 Final ❑ PCA <br />�] <br />Ease/Encroach. <br />❑ Traffic Control <br />❑ <br />Other: � <br />............. <br />m........ ___�_�....�__�. � �..._ _...._ _.._....�... <br />�._ m....� <br />Information <br />�� � Ruired_..� ��...._..._�. ..... �._ ..m ............. �� <br />Company or Vendor Name <br />Thieneman Construction Inc. <br />New Vendor <br />E] Yes ® No E If Yes, Approved by Purchasing <br />MBE/WBE Contractor <br />❑ MBE ❑ WBE <br />MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company <br />Project Name <br />Wastewater Treatment Pla <br />nt ant Secondary Treatment Improvements <br />Project Number <br />114-053 <br />un ource <br />m g <br />_...._n.. �............ .. <br />...... <br />2018 Wastewate r Capital Account. _...___................�..._._..... ___m.,.. ............ <br />Account No. <br />642-0630-415-43-66 <br />Amount <br />$ �.....� <br />Terms of Contract <br />Purpose/Description <br />The Division of Utilities recommends the approval of Chang Orden <br />No. 20 Final and the Project Completion Affidavit for the subject <br />ro'ect as noted in the attached Inter -Office Memordandum and <br />Change Order Documents. <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion,_.. N _. Non -Debarment, E Verif Ir <br />Win, etc. <br />Required For Change Orders Onll <br />Amount of <br />Increase <br />mm. m W . <br />3 07 <br />$ 32 ...._ . __ ,.. me.........._..._ _.... <br />❑ <br />Decrease $ <br />Previous Amount <br />..........................���� ��.�....................��...........��r ��.........�........................���....,,..................._ <br />3,886,597. <br />........... <br />Current Percent of Chan g e: <br />+91�_ <br />„� �_� �...........�.... � <br />0.0 <br />.003% <br />New Amount <br />, <br />$ 13,886,920.98 <br />Total Percent of Change: +16.84% <br />Dispersal After Approval���� <br />Copy Original <br />® ❑ Al Greek, Director of Utilities <br />® ❑ Jacob M. K I o s i n s k i, Assista t City ..�_ ,�� er <br />® ❑ Susan Zeeb, a Director of Fin EngineFinancial Services Wastewat <br />er <br />