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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 10/16/19 <br />��.w�_.���..........���.........e.— --- _................��_��....�................. Department <br />Name Terri Swift/Sean Ward Streets/Sewers <br />BPW Date 10/22/19 Phone Extension 7567 <br />-..u'mltta�Ml� to Board <br />.�1 Pnor to S.......N000.. s <br />BPW Attorney X Attorney Name <br />Clara <br />Dept. Attorney ❑ Attorney Name <br />Purchasing x❑ Michael Schmidt <br />Check the Apkr;,q' priat 'lte�na y ll ,- yl rew R All Submissions <br />Professional Services Agreement ❑ Contract Proposal— <br />❑ Open Market Contract ❑ Amendment/Addendum E] Special Purchase, QPA <br />❑ Bid Opening ❑ Bid Award EJ Req. to Advertise ❑ Title Sheet <br />❑ Quote Opening ® Quote Award Reject Bids/Quotes <br />❑ Proposal Opening ❑ C/O & PCA No. ❑ PCA <br />❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution <br />Other: Allow Terri Swift to A T'k %0 Ease./Encroach <br />Rrr and QI Pul6liC or <br />r~v as II n of BPW <br />pursuant to IC 36-1-12 <br />a t wr a motes r� <br />t "lf <br />Company or Vendor Name <br />Yes ti.,m. .��.�...�,...�_._... .............—._._._.��.�.0 ,.,....._ <br />New Vendor ❑ ❑ If Yes, Approved by Purchasing <br />No <br />MBE/WBE Contractor ❑❑ WBE Completed E-Verify Form Attached ❑ No <br />Project Name Gate Replacement - Street Department u <br />... _... <br />Project Number <br />g p Maintenance <br />Funding Source �MVH/Sews e O wsw& Matn _. .... --. <br />Account No. 202-0607-431.36-01/641-0621-792.36-01 <br />Amount <br />Terms of Contract <br />Purpose/Description Gate damaged by wind during storm of 9/27 28; caused stress fractures b <br />metal framework, twisted entire structure — not repairable. <br />Amount of Increase $ <br />El Decrease _ H ,...,.w..w „u,...,,,.,., <br />Previous Amount $ <br />Increase /o <br />Current Percent of Change: Decrease (w ...__ 0 04 . <br />New Amount $ <br />