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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 8/14/18 <br />Name L Department <br />_qa Timmer DC1 <br />BPW Date 8/28/18 Phone Extension 5841 <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 <br />U Agreement M Contract Ll Proposal U Addendum <br />U Professional Services 0 Resolution <br />F-1 Bid Opening n Bid Award El Req. to Advertise D Title Sheet <br />F1 Quote Opening F1 Quote Award <br />F-1 Change Order No. [::] C/O & PCA No. ❑ P CA <br />El Ease/Encroach. E] Traffic Control <br />I®1 Other: Amendment <br />Company or Vendor Name South Bend Heritage Foundation <br />New Vendor [:1 Yes M No El If Yes, Approved by Purchasing <br />MBEANBE Contractor F-1 MBE F] WBE <br />MBENVBE Contractor Requested Z No E] Yes Name ofCompany <br />_ <br />Project Name Rental Rehabilitation Activity <br />Project Number 18-JC-26 <br />Funding Souirce Community Development Block Gran.t_(CDB9) <br />Account No. 2112M011,460,39,30 <br />Amount $165,000 <br />Terms of Contract 1/01/18,— 12/31/20 <br />Purpose/Description Rehabilitate the rental unit at 307 Chapin Street for lease to a low - <br />mod income tenant <br />0 Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E-Verifv, Iran, etc. <br />Amount of F-1 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 <br />Original <br />M <br />R Judy Love <br />R <br />F] <br />El <br />1:1 <br />