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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date October 1., 201 <br />Department Public <br />Name Scot <br />t Kree er Works <br />BPW Date October 8 2019 <br />Phone Extension 9245 <br />ill. iYhH R11.... M�MMRVNI�VVIVWIWP ��IWNNO�.... i <br />lequrtdmPrior to Submittal to Board <br />BPW Attorney Attorney Name Clara McDaniels <br />Dept. Attorney ❑ Attorney Name <br />Purchasing Michael Schmidt........... <br />Check the Ap Types - kegyLir, <br />Z Professional Services Agreement ❑ Contract <br />Open Market Contract El Amendment/Addendum <br />Bid Opening F-1 Bid Award <br />Quote Opening F-1 Quote Award <br />❑ Proposal Opening ❑ C/O & PCA No. <br />Order, No. El Tral"fzc Control <br />Othe <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 />L J Proposal <br />❑ Special Purchase, QPA <br />Ej Req. to Advertise <br />[� Reject Bids/Quotes <br />PCA <br />F1 Resolution <br />Ease./Encroach <br />❑ Title Sheet <br />WDi tect Lire, Inc. <br />�] Yes M�If Yes, Approved by Purchasing _.._............ <br />_v.w .. _.. <br />F] No <br />[:1 MBE Completed E-Verify Form Attached Yes <br />❑ WBE F] No <br />City of .South BendPoliceDepartment Roofing Workmm m w <br />119-080 <br />Engineering Professional Services <br />....._. m ....... �........ —. <br />101-0602-431.31-06 <br />. me.-.. .... <br />Lump Sum <br />Service A �r+�crzacnt with WDi to .� ��... ���._._�_..�.�.�.....�..�. <br />- ...... _ conduct a roof ins ection and determine a <br />solution for the re airs on tlae 1'oloc�Dc a �t���cnt� ro t; <br />Fo77 <br />" t� Or <br />rders Orel <br />mount of <br />❑ Increase $ <br />—....�...... -.�.. --...... <br />Decrease <br />❑ $ �$ ..._.._.... _... .....w— <br />Previous Amount <br />Increase. m_ ..�.... m_..��............. ����.... � . ....��...... <br />Current Percent of Change: Decrease ------- <br />_... �a <br />New Amount $ <br />Increase % <br />Total Percent of Change: Decrease /o). <br />Time Extension Amount: <br />New Completion Date: <br />