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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 01/29/2025 <br />Name Zach Hurst Department DPW <br />BPW Date 02/11/2025 Phone Extension 3057 <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance ❑ <br />Officer Name <br />and Inclusion Officer <br />BPW Attorney <br />❑ Attorney Name <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. 3 ❑ Traffic Control ❑ Resolution <br />n Other: n Ease./Encroach <br />Company or Vendor Name The MRD Group <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 />Purpose/Description <br />Information <br />❑ Yes ❑ If Yes, Approved by Purchasing <br />❑ No <br />❑❑ MBE Completed E-Verify Form Attached ❑ Yes <br />No <br />Demolition of South Bend Medical Foundation (531 N. Main St.) <br />123-076 <br />River West DA TIF <br />PO-00031911 <br />This change: ($200,000); Revised Amt.: $1,638,562.50 <br />Lump Sum <br />Change Order No. 3 removes backfilling operations from this contract and <br />will eventually transfer to the Beacon Health Parking Lot contract. <br />For Chance Orders Onl <br />Amount of ❑ Increase $ <br />® Decrease ($ 200,000) <br />Previous Amount $ 1,838,562.50 <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />New Completion Date: <br />Increase % <br />Decrease (10.88%) <br />$ 1,638,562.50 <br />Increase % <br />Decrease (7.06%) <br />