Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />12/04/ 18 <br />Lory Timmer <br />Department DCI <br />BPW Date 12/20/18 Phone Extension 5841 <br />;r.... , u �uurewam,wr�Mrv�i�a^rrvrr M01XFf'f�ArRm'(�V.i.ViU89k rm��rer�t,�rs� rv,�uss��wo�u �amawuiawmmmrm�����muemim�wmmmmmi��.mmm�oi!�NNmwmmuam��wrnr�rcmwmwrire�e�mvwar�amaa <br />.. ................................... �. ._,�..�,.. <br />lc,wred Prior to Submittal to Board <br />Legal ® Attorney Name Clara McDaniels Sandra Kenned <br />Controller ® Controller review is required for all Contracts $5,000.00 or more anc <br />greater than one year in length per the City Purchasing Policy <br />Purchasing <br />k the <br />Agreement <br />0 Professional Services <br />Bid Opening <br />Quote Opening <br />Change Order No. _ <br />❑ Ease/Encroach.. <br />❑ Other: Amendment <br />rriate Item T <br />Contract <br />E] Resolution <br />l Bid Award <br />❑ Quote Award <br />❑ C/O & PCA No. <br />❑ Traffic Control <br />Reduired Info <br />Requiredfor All Submissions <br />Proposal <br />❑ Req. to Advertise <br />❑ PCA <br />Addendum <br />❑ Title Sheet <br />Company or Vendor Name Northeast Neighborhood Revitalization Organization, Inc. <br />New Vendor ❑ Yes ® No ❑ If Yes, Approved by Purchasing <br />MBE/WBE Contractor ❑ MBE ❑ WBE <br />MBE/WBE Contractor Requested ® No ❑ Yes Name of Company <br />Project Name A�q_reement for Programs and Services <br />�......a_....va� <br />Project Number <br />Funding Source.......E.D.LT..................._......�.�._..�.�.�.�.�................. .... <br />Account No. 408.1001.460.39.30 ........................�.............�................................................�. <br />..._................................................................................ <br />....................... <br />......�_....... r <br />Amount $75,000 <br />Terms of Contract_....1../0.1.�/.1..g....._.....1...........2/3.�......�.....................��� �„_..�..m..._.......................................................... <br />/19 <br />Purpose/Description Support the NNRO's revitalization efforts in South Bend's Northeast <br />Neighborhood <br />® Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discrimination, Non -Debarment, E Vrm Iran, etc. <br />Amount of ❑ Increase $ <br />[] Decrease $ <br />Previous Amount $ <br />Current Percent of Changer <br />New Amount $ <br />Total Percent of Changer <br />Copy Original <br />® E] Judy Love <br />Di .. ersal After ......... �. Dispersal Approval <br />