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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />March 16th, 2020 <br />PFC Aaron M. Knenner #2174 Department SBPD <br />BPW Date March 24th, 2020 Phone Extension 9018 <br />��ri��wi�ry ,. .m����uH�� mmoHi�iHiHiHi�imm�iHiHiraHiummum�wd�mHUMoo�uHiHi�u mmurvrrv�:+�+�:a,nmrmaeruaar�,. ,.. �a � uuuw�r �ranuuuuuuuuuuuuuuuuuu�www��mmmu�mmwwmmwom ,:mumr�r,�uar� <br />�....._,,,,.� .... ,� __WW_....._WW_...�.�. ... ......._.......�...........�. �w� <br />�.._.....�... Submittalto rm..� <br />Required Prior to Board <br />�...� �. _.��.�,_,,m._, � � ... ..............._ �... <br />Diversity Compliance Officer Name Michael Patton <br />and Inclusion Officer <br />BPW Attorney Attorney Name Clara McDaniels <br />Dept. Attorney Attorney Name Geovanny Martinez <br />. _............ _. <br />Purchasing <br />_. ... _ ..... Check the Aprpriate Item 1 vae� <br />Professional Services Agreement [I Contract <br />�] Open Market Contract <br />[] Amendment/Addendum <br />n Bid Opening <br />EJ Bid Award <br />Quote Opening <br />Quote Award <br />❑ Proposal Opening <br />❑ C/O & PCA No. <br />Chg. Order, No. <br />❑ Traffic Control <br />Other: <br />All Submissions <br />H Proposal <br />❑ Special Purchase, QPA <br />❑ Req. to Advertise <br />❑ Reject Bids/Quotes <br />❑ PCA <br />❑ Resolution <br />m Ease./Encroach <br />e�ri rMecl Informatmon <br />❑ Title Sheei <br />Company or Vendor Name <br />Tire Rack <br />❑ Yes❑ If Yes, Approved by Purchasing __...._... <br />New Vendor <br />® No <br />MBE <br />MBE/WBE Contractor <br />Completed E-Verify Form Attached Nos <br />❑ <br />Project Name <br />2020 1ndemniIication Agreement between COSB & Tire Rack <br />Project Numberu..__.... <br />. .............................M .. <br />....__.... ...... ..................._....... .._ <br />Funding Source <br />Account No. <br />Amount <br />........... ..... ........ ........... ...........__....__............................................. .. ...... <br />Terms of Contract <br />Aril 6"', 20�20 throtr l i October 16"', 2020 <br />Purpose/Description <br />The South Bend Police Department is re uestin Board a roval of the <br />indemnification a eement between the City of South Bend and Tire Rack, <br />This is for use of the Tire Racks training track for the 2020 annual police <br />.... �w <br />µr per cr c V i r l crations VC tra nitss sessions- <br />Ch n�em% cicr Only _....._ ..._._.._._. <br />Amount of <br />Increase $ ..._.._....�... <br />❑ <br />Decrease <br />Previous Amount <br />... ................__. _......................._. <br />$ ......... .....%....__. <br />. _...._............ <br />._._... <br />Increase <br />Current Percent of Change: <br />Decrease „%o mm mmmmm_. J A� <br />New Amount <br />$ <br />Increase % <br />Total Percent of Change: <br />Decrease �..... <br />Time Extension Amount: <br />New Completion Date: <br />