Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date:September 21, 2021 <br />Name:Finnian Cavanaugh Department of Public Works – Engineering Division <br />BPW Date:September 28, 2021 <br />Phone Extension: 5961 or <br />fcavanau@southbendin.gov <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Clara McDaniels <br />Dept. Attorney Attorney Name <br />Purchasing <br />Check the Appropriate Item Type –Required for All Submissions <br />Professional Services Agreement Contract Proposal <br />Open Market Contract Amendment/Addendum Special Purchase, QPA <br />Bid Opening Bid Award Req. to Advertise Title Sheet <br />Quote Opening Quote Award Reject Bids/Quotes <br />Proposal Opening C/O & PCA No. PCA <br />Chg. Order, No. 1 Traffic Control Resolution <br />Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name Asphalt Restoration Services, LLC <br />New Vendor Yes If Yes, Approved by Purchasing <br />No <br />MBE/WBE Contractor MBE <br />WBE Completed E-Verify Form Attached Yes <br />No <br />Project Name Crack Sealing 2021 <br />Project Number 121-020 <br />Funding Source PO-0010107 <br />Account No.455-06-600-506-442001-- <br />Amount $103,500.00 (unchanged) <br />Terms of Contract NTE <br />Purpose/Description Time extension only change order to allow adequate time for <br />completion given delays that occurred in bidding and re-bidding <br />process. <br />For Change Orders Only <br />Amount of Increase <br />Decrease <br />0$ <br />($ ) <br />Previous Amount $ <br />Current Percent of Change: <br />Increase <br />Decrease <br />0% <br />(%) <br />New Amount $ <br />Total Percent of Change: <br />Increase <br />Decrease <br />0% <br />(%) <br />Time Extension Amount: days <br />New Completion Date:October 1st, 2021