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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 05-01-2022 <br />Name: Jacob M. Klosinski Department of Public Works — Engineering Division <br />BPW Date: 05-09-2022 Phone Extension: 9496 <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Michael Schmidt <br />Dept. Attorney ® Attorney Name <br />Michael Schmidt <br />Purchasing ® Mickey Low / Ron O'Connor <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. 001 ❑ PCA <br />❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution <br />n Other: n Ease./Encroach <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Special Contract Provisions <br />Purpose/Description <br />Amount of <br />El <br />Previous Amount <br />Information <br />HRP Construction, Inc. (V-00000775) <br />❑ Yes❑ If Yes, Approved by Purchasing <br />® No <br />❑❑ WBE Completed E-Verify Form Attached ❑❑ Nos <br />Prairie Avenue Water Main Extension <br />117-068 (PROJ00000069; PO-0014485) <br />Water Works Capital; TIF-Southside Development #1; General Fund; <br />Water Works Operations; <br />622-06-604-620-442007; 431-10-102-121-442001; 101-06-600-500- <br />431000; 620-06-604-608-431002 <br />Final Project Cost with approval of CO#1: $1,707,027.02 <br />The Division of Engineering and Division of Utilities (Water Works) requests <br />the Board of Public Works approval of Change Order No. 1 and the Project <br />Completion Affidavit for the subject project. Refer to attached detail <br />regarding changes in scope increase and adjustment of final quantities. <br />For Change Orders Only <br />Increase $ 35,527.02 <br />Decrease ($ ) <br />$ 1,671,500.00 <br />Increase <br />Current Percent of Change: Decrease <br />New Amount $ 1,707,027.02 <br />2.13% <br />Increase % <br />Total Percent of Change: Decrease (2.13%) <br />Time Extension Amount: 0 days <br />New Completion Date: No Change - Project Completed on Time <br />