Opening of Quotes - Hydrant Relocation – Proj No. 120-021 - Selge Construction Co., Inc.

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 02/18/2020 Department Name Alicia Czarnecki Engineering BPW Date 02/25/2020 Phone Extension 5903 MOM=MN IOIY Review and Approval RN*Kqe Prior to Submittal to Board Diversity Compliance ❑ and Inclusion Officer Officer Name BPW Attorney Attorney Name Dept. Attorney ❑ Attorney Name Purchasing ❑ the Appropriate Item Type — Requ Professional Services Agreement ❑ Contract ❑ Open Market Contract ❑ Amendment/Addendum ❑ Bid Opening ❑ Bid Award ® Quote Opening ® Quote Award F] Proposal Opening ❑ C/O & PCA No. E] Chg. Order, No. ❑ Traffic Control E] Other: Required Informati, All Submissions L Proposal ❑ Special Purchase, QPA EJ Req. to Advertise Reject Bids/Quotes PCA Resolution Ease./Encroach ❑ Title Sheet Company or Vendor Name TBD ❑ Yes If Yes, Approved by Purchasing New Vendor ❑ No R❑ MBE MBE/WBE Contractor Completed E-Verify Form Attached ❑ Nos ProjectName Hydrant Relocation Quote_..._ Project Number ........................................................................................................................................w 120-021 Funding Source _ Water Capital._..............................._.....m...m w_�w Account No. 620-0640-606.31-51 Amount _.......... .----- . ........ ............................................... � ��.............�u�� TBD Terms of Contract NTE Purpose/Description Relocation of existing fire hydrant assemblies in antics ation of roadw� �.� �___.. pro4ects in two locations within the Cfty of South Bend. 1N., Eor "h"Ord&rs+ Amount of _§.. __..... ...... Increase $ mm�mmm Decrease $ ).. Previous Amount -_ .... -- _ ............. $ _ Increase % Current Percent of Change: Decrease ( %) New Amount mm ............._ ......._ $ Increase % Total Percent of Change: Decrease %) Time Extension Amount: ,..-„.o... m. ,.. New Completion Date:..____.�..._�__.�..�.