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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 05/17/19 <br />Name Alicia Czarnecki/Roger Nawrot Department 111-111-in—lee—eing <br />- - — ---------- <br />BPW Date 05/28YI9 Phone Extension 5903 <br />H1111111111 WWHNNN(&� <br />'-------iPW Attorney <br />❑ Attorney Name <br />Dept. Attorney Attorney Name <br />Purchasing 1:1 <br />Check the Appropriate Item Type - <br />N Professional Services Agreement F-1 Contract <br />Ej <br />Open Market Contract <br />Amendment/Addendum <br />Bid Opening <br />Bid Award <br />Quote Opening <br />Quote Award <br />E] <br />Proposal Opening <br />CIO & PCA No. <br />E] <br />Chg. Order, No. <br />❑ <br />Traffic Control <br />n Other: <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />Information <br />All Submissions <br />LJ Proposal <br />E] Special Purchase, QPA <br />[:] Req. to Advertise <br />F] Reject Bids/Quotes <br />PCA <br />Resolution <br />Ease./Encroach <br />El Title Sheei <br />Jones Petrie Rafinski CoOil <br />Eyves�f Yes, Approved by Purchasing <br />No <br />❑ MBE Completed E-Verify Form Attached El Yes <br />Ej WBE No <br />Lity of South Bend Wayfinjadinq Signage <br />- — - ------- - <br />119-052 <br />$19,100.00 <br />Design for sign locations and required concrete foundations for wayfindin <br />sipa.E at various . locations in the City. <br />. . ... ... .... . . -- y <br />For Chan Orders On <br />Amount of El increase <br />Decrease <br />Previous Amount <br />Increase % <br />Current Percent of Change: Decrease % <br />New Amount $ <br />Increase % <br />Total Percent of Change: Decrease <br />Time Extension Amount: . ..... <br />New Completion Date: <br />