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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date July 30, 2018 <br />Department Public Works <br />Name <br />Tara Weigand <br />Division/Bureau <br />Engineering <br />BP W Date <br />August 14, 2018 <br />Phone Extension <br />5998 <br />Legal M Attorney Name: Clara McDaniells <br />Controller ❑ Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Purchasing ❑ <br />X Agreement Amendment H Contract LJ Proposal H Addendum <br />El Professional Services ❑ Resolution <br />❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening ❑I Quote Award <br />❑ Change Order No. ❑I C/O & RCA No. ❑ PCA <br />❑ Ease/Encroach. ❑ Traffic Control: <br />❑ Other: <br />Company or Vendor Name <br />EPOCH Architecture + Planning __ <br />F1 Yes ❑ No ❑ If Yes, Approved by <br />New Vendor <br />Purchasing <br />MBE/WBE Contractor <br />❑ MBE ❑ WBE <br />MBE/WBE Contractor Requested <br />❑ No ❑ Yes, Name of Company <br />South Bend Fire Department Training Center Classroom <br />Project Name <br />Building <br />Project Number <br />117-127 <br />Funding Source <br />Emergency Medical Services Caital Fund <br />Account No. <br />287-0902-422.31-06 <br />Amount <br />$ 21,0001.010 <br />Terms of Contract <br />Lump Sum <br />Purpose/Description, <br />Re -design 3000 sf building with SBFD classrooms in order to <br />meet budget constraints <br />❑ Required Contractor's Certification Forms Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verify, 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 />F-1 <br />)ispersal After Approval <br />Kara Boyles, City Engineer <br />Steve Cox, Fire Chief and Todd Skwarcan, Asst. Fire Chief <br />Copelin, EPOCH Architecture + Planni <br />