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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 05-06-2025 <br />Name: Jacob M. Klosinski Department of Public Works – Engineering Division <br />BPW Date: 05-13-2025 Phone Extension: <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Michael Schmidt <br />Dept. Attorney Attorney Name Michael Schmidt <br />Purchasing Mickey Lovy / 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. PCA <br /> Chg. Order, No. Traffic Control Resolution <br /> Other: Ratify Emergency <br />Repair <br /> Ease./Encroach <br />Required Information <br />Company or Vendor Name Selge Construction Company Inc. <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 Emergency Sewer Repair at Western and Chapin Intersection <br />Project Number N/A <br />Funding Source 641-06-602-509-439001 Sewage Works Operations, Other Contract. Svcs. <br />Account No. PO #0037116 <br />Amount $220,379.51 <br />Terms of Contract Time and Materials – Emergency Work <br />Special Contract Provisions <br />Purpose/Description The Division of Engineering and Division of Streets & Sewers requests the <br />Board of Public Works ratify the Emergency Repair Work purchase order for <br />a sewer collapse repair at the intersection of Western and Chapin. A sewer <br />collapse was identified and required structure and pipe replacement due to a <br />fiber optic conduit bore that had been bored through the sewer. <br />For Change Orders Only <br />Amount of Increase <br />Decrease <br />$ <br />($ ) <br />Previous Amount $ <br />Current Percent of Change: <br />Increase <br />Decrease <br /> % <br />( %) <br /> <br />New Amount $ <br />Total Percent of Change: <br />Increase <br />Decrease <br /> % <br />( %) <br />Time Extension Amount: <br />New Completion Date: