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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />07-25-17 <br />Capt. Voros Department SBPD <br />LJ Agreement <br />F-1 Professional Services <br />El Contract Proposal El Addendum <br />X Resolution 0o F <br />El <br />Bid Opening <br />F] Bid Award Req. to Advertise Title Sheet <br />El <br />Quote Opening <br />Quote Award <br />F] <br />Change Order No. <br />C/O & PCA No. E:1 PCA <br />Ease/Encroach. <br />Traffic Control <br />Other: <br />Company or Vendor Name South Bend Police <br />New Vendor 0 Yes M No F1 If Yes, Approved by Purchasing <br />MBE/WBE Contractor F� MBE R WBE <br />MBEANBE Contractor Requested R No E] Yes Name of Company <br />Project Name Retirement of K9 Otter <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description The South Bend Police D913artment requests BPW approval of the <br />resolution for the retirement the 1 Oyr old K9 Otter who has served <br />the Citizens of South Bend for over 8 )Lears. <br />_[:] Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verifv, Iran. etc.) <br />Amount of F1 <br />El <br />increase $ <br />Decrease <br />Previous Amount <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Copy <br />Original <br />M <br />F-1 <br />El <br />P <br />El <br />n <br />Voros <br />Dispersal After Approval <br />