Laserfiche WebLink
BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date June 28 2019 <br />Name Pam MEXjr Department DCI <br />BPW Date Ju 9 2018 Phone Extension 5845 <br />�rvw��im� imm�m�mimwwwoi imuou�mmr�mm0000wm,wwwumomm��wo�mwuw mw�mmmmr�w �w �.. ..mmm......,,,..,�..M <br />_ Required Prior to Submittal to Board <br />BPW Attorney ney Attorney Name <br />Dept. Attorney <br />Attorney Name Sandra Kennedy <br />�..................._......................................................................_._.__.._._................................................................................................................. <br />Purchasing <br />................... ....... .................... ....... ............ .................................................................................._._._....._....... <br />Check theta r° riate Item " p— Rer a�lr ��cI br� All Submissions <br />- <br />reement Z Prof g Contract <br />essional ServicesA <br />i Proposal <br />Open Market Contract <br />❑ Amendment/Addendum <br />❑ Special Purchase, QPA <br />F] <br />Bid Opening <br />0 <br />Bid Award <br />❑ Req. to Advertise <br />❑ Title Sheet <br />Quote Opening <br />❑ <br />Quote Award ❑ Reject Bids/Quotes <br />Proposal Opening <br />C/O & PCA No. <br />❑ PCA <br />❑ <br />Chg. Order, No. <br />Traffic Control <br />n Resolution <br />Other <br />Ease./Encroach <br />... <br />...��. 1� �� rm�.. ...... ...... ..m . <br />ed Information <br />Company or Vendor Name <br />Indiana Housing and Community Development Authority <br />(IHCDA) <br />New Vendor <br />❑ Yes❑ If Yes, Approved by Purchasing <br />No <br />MBE/WBE Contractor <br />Completed E-Verify Form Attached <br />MBE <br />❑Nos <br />Project Name <br />IFPN Mortgage Foreclosure Counseling <br />Project Number <br />N/A <br />w.....�....... _...... _.... ................................ ................................................................................_....................................... <br />Funding Source <br />IHCDA - State of Indiana <br />Account No. <br />N/A <br />Amount See Purpose <br />Terms of Contract Jul�l, 20 18 December 31, 2019 .... _ <br />Purpose/Description Amendment to original contract to extend services to December 31, 2019. <br />Fee for service contract -City is paid for foreclosure counseling to eligible <br />applicants based on rates in contract; applicants referred through and/or <br />eligible under Foreclosure Prevention <br />Network <br />E..�_... =.- . ............... --For Change Orders Only <br />Amount of Increase $ <br />�I 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 />( %) <br />New Completion Date: <br />