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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 6/25/2019 mmmmmm <br />Name Pam Meyer Dep <br />artment ment I <br />BPW Date 7/9/2019 Phone Extension 5845 <br />�!�mmuimuiui�m�mmarrrarwie ✓rwiwHrrn�u�r�r�zaw�wr,�,�a.�r uumumuuu�iuiuiuiuiwuwuwuwuwuuiuwiuivi�rtrrt�r�iv... �rr�unn�w�w�wu�v�mmmimmmimimimmmmmw�im��uumumiWmwmmu�uiww�uuwrimaiarur�,w!,�n�����. <br />...._�,_. _ T'.... .._.� <br />Rct�ed Prior to Submittal to Board <br />�... .�............... .—._..a <br />BPW Attorney ® Attorney Name Clara McDaniels <br />Dept. Attorney ® <br />Attorney Name <br />Sandi Kenned <br />Purchasing ® <br />Michael Schmidtt <br />......._....... Check the q�RiLopriatc Item Tie_ <br />_._ ..... <br />l udrcclafiarAll Submissions�IT�m—....� ... _..... <br />Professional Services Agreement EJ Contract <br />❑ Proposal <br />�j <br />Open Market Contract <br />Amendment/Addendum <br />Special Purchase, QPA <br />Bid Opening <br />F-1 <br />Bid Award <br />® Req. to Advertise ❑ Title Sheet <br />Quote Opening <br />[] <br />Quote Award <br />❑ Reject Bids/Quotes <br />[] <br />Proposal Opening <br />❑, C/O & PCA No. <br />PCA <br />F <br />, Chg. Order, No. <br />❑ Traffic Control <br />❑ <br />Resolution <br />Other: <br />Ease./Encroach <br />Required Information <br />Company or Vendor Name South Bend Housing Authority IT ........ ..... . <br />Yes R If Yes, Approved by Purchasing <br />New Vendor Z No <br />MBE/WBE Contractor MBE Completed E-Verify Form Attached ® Yes <br />❑ WBE ❑ No <br />Project Name perations Manager for Federal l Lead Grant <br />ProjectNumber .........._......_....�.......__.............. m.wW� ..�.��_��............._ <br />................. <br />Funding Source <br />Account No. 2.�1.2_..1036-331005.01....._�—. <br />Amount$65,00.0.................................................._. wwww �....__ <br />Terms of Contract May 1, 2019 — May 31, 2020 <br />Purpose/Description Support for an Operations Manager who will assist in the day-to-day <br />implementation of the federal lead grant. <br />For Chan a Orders Only <br />Amount of <br />Increase $ <br />.................... <br />Decrease $ <br />Previous Amount <br />$ <br />....I........�._............ <br />ncrease <br />_.......................w_.......... <br />% <br />...... .....................w----_w ..w_ <br />Current Percent of Change: <br />Decrease <br />.... ..................... <br />( %) <br />NewAmount <br />$ <br />—...................................... .... <br />Increase <br />......... <br />% .... ...................—._ _.��� <br />Total Percent of Change: <br />Decrease <br />......_m <br />... ........... ___ 0/0) — <br />Time Extension Amount: <br />NewCompletion Date: <br />...... .......... ..................... ......................_.............................. <br />