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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 12/20/16 <br />Name Aaron Kobb <br />Department Community <br />Investment <br />BPW Date 12/22/16 Phone Extension 5823 <br />Attorney Name Ben Dougherty <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller ❑ and greater than one year in length per the City Purchasing <br />Policy <br />Purchasing ❑ <br />Professional Services <br />Bid Opening <br />Quote Opening <br />Chg Order No. <br />Ease./Encroach. <br />Other: Lease Renew: <br />Contract <br />❑ Bid Award <br />❑ Quote Award <br />❑ C/O & PCA No. <br />❑ Traffic Control <br />Company or Vendor Name LePeep <br />❑ Yes <br />New Vendor ❑ No <br />MBE/WBE Contractor ❑ MBE <br />❑ WBE <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of <br />of South Bend, Inc <br />Proposal <br />❑ Req. to Advertise <br />❑ PCA <br />❑ Resolution <br />I-1 Claim <br />If Yes, Approved by Purchasing <br />❑ Title Sheet <br />Completed E-Verify Form Attached ❑ Yes <br />❑ No <br />$207,708.48 (six year lease term total) <br />Lease renewal between landlord and tenant for the space located <br />in the Michigan Street Shops 127 South Michigan St <br />Increase <br />Decrease <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Time Extension: <br />Dispersal After Approval <br />Copy Original <br />❑ ® Aaron Kobb (2 Originals) <br />❑ ❑ <br />❑ ❑ <br />