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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />10/9/17 <br />John Lankowicz <br />Department Innovation & Tech <br />BPW Date 10/24/17 Phone Extension 7580 <br />Re aired Prior to Submittal to Board <br />Legal <br />Controller ® Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing ❑ <br />Lj Agreement LJ -- <br />Contract Proposal ❑Addendum <br />❑ Professional Services ❑ Resolution <br />❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening ❑ Quote Award <br />❑ Change Order No. ❑ CIO & PCA No. ❑ PCA <br />❑ Ease/Encroach. ❑ Traffic Control <br />M Other: Contractual <br />Company or Vendor Name Microlntegration, <br />New Vendor 0 Yes ® No <br />MBE/WBE Contractor ❑ MBE ❑ WBE <br />MBE/WBE Contractor Requested ® No ❑ Yes <br />Project Name GIS Servers <br />Project Number <br />If Yes, Approved by Purchasing <br />Name of Company <br />Funding Source Wastewater <br />Account No. 641 0630 793 6335 <br />Amount $5400 ($ 1 800 /month <br />Terms of Contract <br />Purpose/Description <br />Amount of ❑ <br />El <br />12/31/17 <br />Virtualized Servers required for new GIS architecture <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verifv. Iran. etc. <br />Increase $ <br />Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount $ <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy Original <br />® ❑ John Lankowicz, jlankowi@southbendin.gov <br />❑ ❑ <br />❑ ❑ <br />