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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date June 18, 2018 <br />Name Austin Gammage Department DCI <br />BPW Date June 26, 2018 Phone Extension 5,842 <br />Legal M Attorney Name Sandra Kennedy <br />Controller El 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 F <br />"Agreement <br />El Professional Services <br />F-1 Bid Opening <br />F Quote Opening <br />E] Change Order No. <br />El Ease/Encroach. <br />F-1 Other: <br />Company or Vendor Name <br />New Vendor <br />MBEANBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />LJ Contract <br />M Resolution,�.t <br />❑ Bid Award <br />F-1 Quote Award <br />F C/O & PCA No. <br />F] Traffic Control <br />Michiana Partnership Inc <br />Om-m ilk <br />117111-INO <br />Regional Cities Agreement <br />EDIT <br />408-0401-415-39.30 <br />Z= <br />El Req. to Advertise <br />am <br />Addendum <br />El Title Sheet <br />Amount $ 15,000 <br />Terms of Contract <br />Purpose/Description To provide funding to Regional Cities of Northern Indiana towards their <br />efforts of perfroming economic development functions within St. Joseph <br />County. <br />F-1 Required Contractor's Certification Form Attached (Non <br />Collusion, Non -Discrimination, Non -Debarment, E-Verifv, Iran, etc.) <br />Amount of LJ Increase $ <br />n 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 Austin Gammage <br />F-1 Sandra Kennedy <br />