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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />March 12. 2018 <br />Jeff Hudak <br />Department Central Services <br />BPW Date March 27, 2018 Phone Extension 574-235-9318 <br />Re aired Prior to Submittal to Board <br />Legal ® 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 ® Michael Schmidt <br />❑ Other: <br />Required Information <br />Company or Vendor Name <br />New Vendor <br />MBEMIBE 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 />U Yes U No - U If Yes, Approved by Purchasing <br />I-1 MBE F-1 WBE <br />❑ No ❑ Yes Name of Company _ <br />Spec J - Thirty -Nine (39) more or less 2018 or Newer All Wheel <br />Drive Police Patrol Vehicles <br />2018 Police Department Capital Principal 404-0401-415-37-11 & <br />Interest 404-0401-415-37-12 (subiect to lease funding) <br />N <br />Bid Opening Date: <br />❑ 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 />Copy <br />Original <br />® <br />❑ <br />® <br />❑ <br />❑ <br />11 <br />Jeff Hudak <br />% <br />Dispersal After Approval <br />Ken Glowacki, Chad Goben, Don Galeziewski <br />