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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 05/06/2020 <br />Department Engineering <br />Name Toy Villa <br />BPW Date 05/012/2020 Phone Extension5920 <br /> <br />Required Prior to Submittal to Board <br />BPW Attorney Attorney Name <br />Dept. AttorneyAttorney Name <br /> <br />Purchasing <br />Check the Appropriate Item Type –Required for All Submissions <br />Professional Services AgreementContractProposal <br />Open Market Contract Amendment/Addendum Special Purchase, QPA <br />Bid Opening Bid Award Req. to Advertise Title Sheet <br />Quote Opening Quote Award Reject Bids/Quotes <br />Proposal Opening C/O & PCA PCA <br />No.2(Final) <br />Chg. Order, No. Traffic Control Resolution <br />Other: Ease./Encroach <br />Required Information <br />Company or Vendor Name Geograph Industries, Inc <br /> Yes If Yes, Approved by Purchasing <br />New Vendor <br /> No <br /> MBE Yes <br />MBE/WBE Contractor Completed E-Verify Form Attached <br /> WBE No <br />Project NameCity of South Bend Wayfinding Signage Program - Phase 1 <br />Project Number 119-052R <br />West Washington TIF ($10,000.00) <br />River East TIF ($30,000.00) <br />River West TIF ($25,700.00) <br />Funding Source Professional Services (rest of amount) <br />324-1050-460-42-03 ($10,000.00) <br />429-1050-460-42-03 ($30,000.00) <br />422-1050-460-42-03 ($25,700.00) <br />Account No. 217-0602-367-31-06 (rest of amount) <br />Amount <br />Terms of Contract <br />Purpose/DescriptionProject Closeout <br />For Change Orders Only <br />$ 0 <br /> Increase <br />Amount of <br />Decrease ($1,686.000) <br />Previous Amount$ 139,157.00 <br />0% <br />Increase <br />Decrease (1.21%) <br />Current Percent of Change: <br /> <br />New Amount $ 137,471.00 <br />% <br />Increase <br />Decrease (1.21%) <br />Total Percent of Change: <br /> <br />Time Extension Amount: <br />New Completion Date: 1/24/2020 <br />