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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />1/18/18 <br />Daniel O'Connor <br />Department Innovation & Tech <br />BPW Date 1123/18 Phone Extension 6201 <br />M Agreement <br />U Contract U Proposal Ll Addendum <br />❑ Professional Services <br />❑ Resolution <br />❑ Bid Opening <br />❑ <br />Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ <br />Quote Opening <br />❑ <br />Quote Award <br />❑ <br />Change Order No. <br />❑ CIO & PCA No. ❑ PCA <br />❑ <br />Ease/Encroach. <br />❑ Traffic Control <br />I-1 <br />Other: <br />Company or Vendor Name Interlink Group <br />New Vendor ® Yes ❑ No ® If Yes, Approved by Purchasing <br />MBEIWBE Contractor ❑ MBE ❑ WBE <br />MBEIWBE Contractor Requested ❑ No ❑ Yes Name of Company <br />Project Name City of South Bend/Century Center Website hostin <br />Project Number nla <br />with Interlink <br />Funding Source IT Operating <br />Account No. 279-0672-415-36-04 (IT Operating) <br />Amount $1,980 for a one year agreement ($65x12=780) + ($1,200 One <br />time). A Single payment in the full amount will be invoiced <br />Terms of Contract Agreement <br />Purpose/Description Agreement with Interlink Group to Migrate as is and then host the <br />CentuN Center Website currently being hosted by another vendor <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verifv, Iran, etc.) <br />Amount of ❑ 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 />❑ <br />❑ <br />❑ <br />❑ <br />Dan O'Connor <br />Dispersal After Approval <br />