Supplemental Agreement No 2 - DLZ Indiana - Bendix Drive Reconstruction

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date December 14, 2018 Name Roger T. Nawrot Department Public Works Division/Bureau Enginee ring BPW Date December 20, 2018 Phone Extension 5932 WWMWm01101IVIWVIVI ..nm+mn .. VIIW'idWNaNiiY.MN( ,,, MY&NI lldHlAMR"dlNlIIMMm Re uired�Prior to Submittal to Board Legal ® Attorney Name: Controller ® Controller review is required for all Contracts $5,000.00 or more and greater than one year in length per the City Purchasing Policy Purchasing �mmmmmCheck the L Agreement ® Professional Services Bid Opening El Quote Opening ❑ Change Order No. El Ease/Encroach. Other: Amendment No. 2 Topriate Item Type — El Contract ❑ Resolution ❑ Bid Award Quote Award C/O &PCANo. El Traffic Control: for All Submissions FP oposal ❑ Req. to Advertise Required Information ❑ PCA Addendum ❑ Title Sheet Company or Vendor Name DLZ Indiana LLC .� Yes ® No ❑ If Yes, Approved ❑ by New Vendor Purchasir MBE/WBE Contractor MBE [:]I WBE MBE/WBE Contractor Requested q ❑ ......... _... ......... m No Yes Name of Company � Project Name Bendix Drive Reconstruction Project Number 114-065 Funding Source LOIT Special Distribution ... Account No. 257-0608-431.42-96 Amount $32,250.00 New Total Contract Amount $535,2 _............. u 50.00 Terms of Contract Not to Exceed Purpose/Description _ The Amendment No. 2 is for adding a Subsurface Utility Engineerin Inyesti ation. El Required Contractor's Certification Forms Attached ched (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) L . ....................... . ............ ......... a uired For Change Orders Only ............... Amount of El F] Increase Decrease