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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />BPW Date <br />03/07/2019 <br />Division Chief Lancaster <br />03/26/19 <br />Department SBPD <br />Phone Extension 9301 <br />.............. ...._ .._....._ ........ _ ............ <br />Required Prior to Submittal to Board <br />Legal ® Attorney Name Geovanny Martinez <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 />Check the <br />F-1 Agreement <br />Professional Services <br />F� Bid Opening <br />F-1 Quote Opening <br />F-1 Change Order No. <br />Ease/Encroach. <br />Other; <br />roriate Item Type <br />F Contract <br />Z Resolution's . <br />F] Bid Award <br />Quote Award <br />❑C/O &PCANo. <br />❑ Traffic Control <br />— Required for All Submissions <br />E] Proposal R Addendum <br />X)6 [:] Req. to Advertise ❑ Title Sheet <br />ired Information <br />❑ PCA <br />Company or Vendor Name <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 Posthumous gift of firearm to Father of Donald Knabenshue <br />Project Number <br />Funding Source <br />Account No. _ <br />Amount $ <br />Terms of Contract <br />Purpose/Description The South Bend Police Dept. reguests that the Board l of Public <br />Works declare Officer Donald Knabenshue's Smith & Wesson M&P <br />handgun as surplus property no longer useful to the city. Serial No <br />HKB6204.This declaration will authorize the presentation of the <br />above listed firearm as a tribute for his 22 yrs of service to the City, <br />Deceased: 01-05-19. Officer Knabenshue passed away while an <br />active member of the South Bend Police Department. <br />❑ Required Contractor's Certification Form Attached (Non - <br />Collusion„ Non -Discrimination -Non -Debarment, E-Verify„ Iran, etc.) <br />Required For Change Orders Only <br />Amount of Increase $ ....._.. <br />Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % _ ... ............... <br />_ IT <br />New Amount $ <br />Total Percent of Change: �IT % <br />Dispersal After Approval <br />Copy Original <br />® F-� Chief Lancaster <br />