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BOARD OF PUB1,IC WORKS <br />AGENDA rrEM REVIEW REQUEST FORM <br />1-9. <br />Date Augusty, 2018 <br />Name Pam Meyer Department DC1 <br />BPVV Date August 14, 2018 Phone Extension 5845 <br />Required Prior to Submittal to Board <br />Legal Attorney Name Clara McDaniels , Sandra Kennedy <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 El <br />X Agreement <br />F-1 Professional Services <br />Bid Opening <br />Quote Opening <br />❑ Change Order No. <br />F1 Ease/Encroach. <br />n Other: <br />]a Contract <br />El Resolution <br />0 Bid Award <br />F-1 Quote Award <br />0 C/O & PCA No. <br />El Traffic Control <br />M �= <br />F] Req, to Advertise [:] Title Sheet <br />NMA <br />Company or Vendor Name Urban Enterprise Association of South Bend, Inc. <br />New Vendor El Yes M No El If Yes, Approved by Purchasing <br />MBENVBE Contractor E] MBE F1 WBE <br />Project Name, City Pilot Homeowner Repair Program <br />Project Number N/A . .. . ...... <br />Funding Source COIT <br />Account No. N/A <br />Amount $ 300,000.00 <br />Terms of Contract 7/23/18-,12/31/19 <br />Purpose/Description To administer a homeowner repair program in areas directed by City. <br />[J Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) <br />Required -for Chap <br />Amount of ❑ 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 />❑ Pam Meyer, DCI <br />.. ..... . ..... ..... ....... <br />El <br />