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Date <br />Name <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />r., <br />C. Voros <br />Department SBPD <br />BPW Date 06-12-18 Phone Extension 7770 <br />Required Prior to Submittal to Board <br />Legal Z Attorney fume Clara McDaniels <br />Controller z 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 ❑ <br />Check the Appropriate Item Type -- Required for All Submissions <br />❑ Agreement El Contract ❑ Proposal ❑ Addendum <br />❑ Professional Services ❑ Resolution <br />❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening ® Quote Award <br />❑ Change Order No. ❑ C/O & PCA No. ❑ PCA. <br />© Ease/Encroach. ❑ Traffic Control <br />Other: <br />Company or Vendor Name <br />New Vendor ❑ Yes ® No ❑ If Yes, Approved by Purchasing <br />MBEIWBE Contractor ❑ MBE ❑ WBE <br />MBEIWBE Contractor Requested ❑ No F-1 Yes Name of Company <br />Project Name Forensic Lab upgrade <br />Project Number <br />Funding Source General fund <br />Account No. 1101-0801-421' .39-8'0 <br />Amount $ 33,000 <br />Terms of Contract <br />Purpose/Description The South Bend Police Department requests BPW approval for <br />opening and awarding of guotes for Forensic Lab upgrade on which <br />the quote request was sent out on 11-20-17. <br />Required Contractor's Certification Farm 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 />11 <br />❑ <br />El <br />0 <br />C. Varos <br />Dispersal After Approval <br />