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Date <br />Name <br />LTM pie I MIN NO DJUT 5 N OLTA I DMATM-4 KI I U I t <br />01/29/18 <br />Sgt. Goben Department SBPD <br />BPW Date 02/13/18 Phone Extension 7520 <br />Required Prior to Submittal to Board <br />Legal Z Attorney Name Clara cDaniels <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 />03=0/:� <br />El Agreement <br />0 Professional Services <br />El Contract L1 Proposal R Addendum <br />JZ ResolutioncV, NVI <br />R <br />Bid Opening <br />El Bid Award El Req. to Advertise 0 Title Sheet <br />El <br />Quote Opening <br />R <br />Quote Award <br />[] <br />Change Order No. <br />El <br />C/O & PCA No. [:1 PCA <br />El <br />Ease/Encroach, <br />R Traffic Control <br />R <br />Other: <br />Company or Vendor Name South Bend Police <br />New Vendor F1 Yes D No 0 If Yes, Approved by Purchasing <br />MBEMBE Contractor [] MBE F-1 WBE <br />MBENVBE Contractor Requested E] No [:]Yes Name of Compainy_ <br />Project Name Retirement of K9 Dex <br />Project Number <br />Funding, Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Amount of ❑ <br />$1.00 <br />The South Bend Police Dept, reguests that the Board of Public Works <br />approve the reolution for the retirement of the 8 year old K9 Dex and the <br />purchase of Dex, by the handler Jeff Chamberlain for 1.00 and all expenses <br />incurred in connection with the dogi after its retirement,. <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 />Copy Original <br />0 ❑ Sgt. Goben <br />