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Date <br />Name <br />BPW Date <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />1117117 <br />Jeff Hudak Department <br />11/28/17 <br />Central Services <br />Phone Extension 574-235-9316 <br />U <br />Agreement <br />L <br />Contract U Proposal U Addendum <br />❑ <br />Professional Services <br />❑ <br />Resolution <br />❑ <br />Bid Opening <br />® Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening <br />❑ Quote Award <br />❑ Change Order No. <br />❑ CIO & PCA No. ❑ PCA <br />❑ Ease/Encroach. <br />❑ Traffic Control <br />F] Other: <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />MBEMIBE Contractor <br />Requested <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />McDaniel's Harley-Davidson <br />❑ Yes ® No ❑ If Yes, Approved by Purchasing <br />I-1 MBE hl WBE <br />❑ No ❑ Yes Name of Company <br />Spec Q — Four (4) more or less 2017 or Newer Police Motorcycles <br />with Equipment <br />2017 Police Department Capital Budget <br />216-0801-421-43-02 <br />$ 63, 338.00 <br />Bid Opening Date: 818117 <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verifv, Iran, etc. <br />Amount of U Increase <br />❑ Decrease <br />Previous Amount <br />Current Percent of Change <br />New Amount <br />Total Percent of Change: <br />Copy <br />Original <br />❑ <br />❑ <br />Dispersal After Approval <br />Jeff Hudak & Sheila Enos <br />Ken Glowacki, Chris Voros, Don Galeziewski <br />