Professional Services Agreement - Request for Qualifications Agreement for Print Shop Services Awarded - Kill-N-Em, Inc. dba Carothers Printing

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date Name 10/29/19 Michael Schmidt Department gtywidemm mmmmmmmm BPW Date November 12, 2019 Phone Extension 574-235-9977 aartmun:�rwurnwauwirarrrr�mr,�mnr u��,��.ezn. �:�,eau+�.m�iuwa��wrar��saumm,awrwnmreibmuN�mr.rrw �..��N... .... _.. u. mtr�ra;�m.�rn+e��m� ,.,,�. esrtr^emw�u^s �. Submittal to Boa m.� Ro uired Prior t Board Legal Attorney Name Clara McDaniels Controller review is required for all Contracts $5,000.00 or more Controller ® and greater than one year in length per the City Purchasing Policy Purchasing ® Michael Schmidt ��..(�.... �wwwww Check the Appriiate Item Type a/rod' for All Submissions Agreement ® Contract A--, Asvu �.� Proposa.I.......... Addendum...m �I Professional Services ❑ Amendment E] Bid Opening El Bid Award ` Req. to Advertise ❑ Title Sheet ❑ Quote Opening F-1 Quote Award Chg Order No. ❑ C/O & PCA No. PCA Ease./Encroach. ❑ Traffic Control Resolution �j Other: Claim .................� ...._ ...... Recuired Inform.....�...ww..��_�. ation Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description Kill-N-Em, Inc. dba Carothers Printing Comp ❑' Yes If Yes, Approved by Purchasing ❑ No ❑ MBE Completed E-Verify Form Attached El Yes ❑ WBE ❑ No Print ShopServiceVendor All City Departments See attached Execute Contract stemming from RFQ or Amount of ❑ Increase $ �❑ Decrease $ Previous Amount Current Percent of Change New Amount Total Percent of Change: Time Extension: Dispersal After Approval Copy Original Michael midt, Matt Chlebowsk, Ben Dougherty ® ❑ . Dan Parkeh..........................