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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />....... ..�......... . . ........................... <br />Date 7/8/19 <br />Name Liz Maradik Department DCI <br />BPW Date 7/9/19 Phone Extension x5821 <br />.�..uu✓S�S�'FdFVFvif{A4N4N�!^""dAYIP . vn��.r:-+Vv✓"� v,.-;.u,. ar�r-=m5atui�wm ¢dt, � �,W�YVTY�M!fi�'/G�tt"r' R�,,,,,,,,,,,,,, ,,,---;,�aii pJl', 3. reu.:8e&GEiD.iW.1Ri914d dikf+ACk�Fdi1i1i1i1Yr'ittrirYu�tk)n�A'�'2a.'crtu�'d;G;�t�r'fi'�rM4ttIII�i�iI�hII�VfBkM19lf�?�kMV�:e� <br />lie wired Prior to Submittal to Board <br />n .. .. �. _...._.._ _ . .._ .. m �m m _ ... _ d .,....... <br />.... ........ ...... <br />BPW Attorney Attorney Name Clara McDaniels <br />Dept. Attorney F-1I Attorney Name <br />-------- — ------- ..__.,.,._... _..._.__..... <br />Purchasing q—] <br />Check the <br />Professional Services Agreement <br />El Open Market Contract <br />Bid Opening <br />Quote Opening <br />EJ Proposal Opening <br />Chg. Order, No. <br />Other: M O [1 <br />ite Item I"y � <br />Contract <br />y!,rCarl16r All Submissions <br />7 Amendment/Addendum <br />❑ Bid Award <br />❑ Quote Award <br />C/O & PCA No. <br />❑ Traffic Control <br />le(puiped Information <br />U Proposal <br />❑ Special Purchase, QPA <br />E] Req. to Advertise <br />E] Reject Bids/Quotes <br />PCA <br />❑ Resolution <br />Ease./Encroach <br />❑ Title Sheel <br />Company or Vendor Name <br />South Bend Civic Theatre <br />New Vendor <br />.�� <br />Yes If Yes, Approved by Purchasing <br />N <br />MBE/WBE Contractor <br />MBE Completed E-Verify Form Attached El YNeos <br />Project Name <br />Project Number <br />NA <br />Funding Source <br />NA <br />Account No. <br />Amount <br />Terms of Contract <br />.........�.�...............................-._.,.............................. <br />Purpose/Description <br />Agreement for the periodic and temporaryc_los................................................................... ___._........_._.... <br />ure of the alley located behiihi� <br />the civic theatre related to special events. <br />For Chan Orders Only....._ _ <br />Amount of El Increase $ <br />E] Decrease ($ J <br />Previous Amount <br />$ ,..........................------ -----........_..................m.... <br />����������.... <br />IncreaSe <br />/o <br />Current Percent of Change;, <br />Decrease <br />�_ /o <br />New Amount <br />$__ ........................................... <br />...................... ........... - <br />Increase <br />Total Percent of Change: <br />Decrease <br />.................. <br />( % <br />Time Extension Amount: <br />New Completion Date: <br />