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FMM D10 17M V V 0JJJ Cki QMJ I MAN ti K910 <br />03/19/18 <br />. Goben <br />3/27/18 <br />Department <br />Phone Extension <br />Required Prior to Submittal to Board <br />Legal Z Attorney Name Clara McDaniels <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 1:1 <br />Agreement <br />Z Contract L Proposal L Addendum <br />Professional Services <br />E] Resolution <br />F� <br />Bid Opening <br />El Bid Award 0, Req. to Advertise El Title Sheet <br />Quote Opening <br />F-1 <br />Quote Award <br />Change Order No., <br />R <br />C/O & PCA No. ❑ PCA <br />El <br />Ease/Encroach. <br />❑ Traffic Control <br />R <br />Other: <br />Company or Vendor Name Testing for Public Safet _y <br />New Vendor F] Yes El No E If Yes, Approved by Purchasing <br />MIBE/WBE Contractor R MBE R WBE <br />MBE/WBE Contractor Requested E] No R Yes Name ofCompany <br />_ <br />Project Name Promotional Testing <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract Annual <br />Purpose/Description The South Bend Police, Dept. requests that the Board of Public Works <br />approve the contract with Testing for Public Safety, LLC, to assist and provide <br />testing for the prornotional process within the South Bend PD. <br />E] Required Contractor's Certification Form Attached (Non - <br />Collusion. Non -Discrimination. Non -Debarment., E-Verifv. Iran. etc.) <br />Amount of H 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 />0 F-1 Sgt. Goben <br />El E] <br />F F <br />