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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date February 18. 2019 <br />Department Community <br />Name Alkeyna Aldridge Investment <br />BPW Date February 26 2019 NNYm Phone Extension 5896 <br />_......._ _......... ...... ............ <br />.._ <br />Required Prior to Submittal to Board <br />Department ...111, <br />... ..... ..... <br />....w <br />Attorney: <br />Sandra <br />Legal ® Kennedy <br />BPW Attorney: <br />Clara <br />McDaniels <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller ® and greater than one year in length per the City Purchasing <br />Policy <br />Purchasing <br />at Item Ty <br />pe .. <br />.M__..... m... Check the App'ro..._w_P ' "�pe .�1R'eclulrcd for All Srnls,ioo; . <br />ZA Agreement �] Contract Proposal Addendum <br />❑ Professional Services R Amendment <br />❑ Bid Opening E] Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />El Quote Opening El Quote Award <br />❑ Chg Order No. El C/O & PCA No. PCA <br />Ease./Encroach. Traffic Control ❑ Resolution <br />R Other: If-1Claim <br />_ <br />Required Information <br />Company or Vendor Name <br />United Wa of St. Joseph County <br />If Yes, Approved by Purchasing <br />New Vendor <br />® No <br />MBE/WBE Contractor <br />❑ MBE Completed E-Verify Form Attached El Yes <br />WBE ❑ No <br />Project Name <br />Neighbor to Neighbor Engagement __..__ ..._............................ ...... <br />Project Number <br />19JO24 <br />Funding Source <br />EDIT <br />Account No. <br />........... <br />408-1001-460._.3.1.....06................................... _www _.........__.....,,, �..m. <br />Amount <br />Not to exceed t25,000 <br />Terms of Contract <br />March 1 2019-December 3���1, 2019 <br />Purpose/Description <br />Nei hborhood Programs &........_......_ �.. <br />Services <br />For Change Orders Ondr ITmmm <br />....................._ .... _. <br />Amount of El Increase $ <br />F] Decrease $ <br />Previous Amount $ <br />Current Percent of Change; <br />New Amount $ <br />Total Percent of Change: <br />Time Extension: <br />Dispersal After Approval <br />Copy Original <br />