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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date September 18, 2018 <br />Name Pain Mever Department DCI <br />BPW Date September 25, 2018 Phone Extension 5845 <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 n <br />N Agreement <br />F] Professional Services <br />Bid Opening <br />Quote Opening <br />F-1 Change Order No. <br />R Ease/Encroach. <br />F-1 Other: <br />Company or Vendor Name <br />S Contract <br />F1 ResoIution <br />Bid Award <br />Quote Award <br />& PCA No. <br />El Traffic Control <br />9 =4 <br />El Req. to Advertise <br />IMEN <br />F.15 1114 =1 I I <br />F1 Title Sheet <br />Indiana Housing and Community Development Authority (IFICDA) <br />New Vendor 0 Yes Z No El If Yes, Approved by Purchasing <br />MBEANBE Contractor F] MBE n WBE <br />Project Name Supplemental Disaster Recovery -Owner Occupied Rehab, for Lead <br />Project Number <br />Funding Source CDBG Disaster Recovery Federal Funding through IHCDA <br />Account No. <br />Amount $__143,906.00 <br />Terms of Contract 8/31/18-12/31/18 <br />Purpose/Description To administer a program to identify and control lead - based paint hazards <br />in eligible privately owned owner occupied housing units. <br />El Required Contractor's Certification Form Attached (Non - <br />Collusion. Non -Discrimination, Non -Debarment, E-Verifv, Iran, etc.) <br />Amount of F1 increase $ <br />El Decrease $ <br />Previous Amount $ <br />Current Percent of Change: <br />New Amount $ <br />Total Percent of Change: <br />Copy Original <br />M M Pam <br />F-1 ❑ <br />El El <br />Dispersal After Approval <br />, I)CI <br />