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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date ay 4', 2020 <br />Name PFC Aaron M. Kneper #2174 Department SBPD <br />_,............................p�.... � m- — -. <br />u�mmAmAmm �men"rr�mrssoAmmmmmnmmoArmvm <br />BPW�Datm�May .12�12�N��vN�: .��. Phone Extension 901O <br />_._..... _._ _ .m_ ... .. _ <br />_.. Required Prior to Submittal to Board <br />Diversity Compliance E] Officer Name <br />and Inclusion Officer <br />BPW Attorney Z Attorney Name Clara McDaniels <br />Dept. Attorney Z Attorney Name Geovanny Martinez <br />Purchasing ❑ <br />Check the Ap pro iri, to Item � a mmm 1 <br />EJ <br />Professional Services Agreement ❑ Contract <br />F] <br />Open Market Contract ❑ Amendment/Addendum <br />n <br />Bid Opening ❑ Bid Award <br />Quote Opening El Quote Award <br />Proposal Opening F] C/O & PCA No. <br />E, <br />Chg. Order, No. El Traffic Control <br />F Other: <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 />Amount of <br />Previous Amount <br />r All Submissions <br />U Proposal <br />Special Purchase, QPA <br />El Req. to Advertise <br />❑ Reject Bids/Quotes <br />❑ PCA <br />® Resolution <br />Ease./Encroach <br />Required Information <br />❑ Title Sheel <br />� J, Yes If Yes, Approved by Purchasing <br />❑ No <br />❑ MBE Completed E-Verify Form Attached Yes <br />❑ WBE [ No <br />Retirement Gift of SBPD Duty Firearm to Charles Roth <br />The South Bend Police Department requests the Board declare Officer Chark <br />Rothy's Smith & Wesson M&P9 handgun, serial #NDT0934 as surplus prop( <br />no longer useful to the City. This declaration will authorize the presentation <br />the above listed firearm as a tribute for his 20 years of service to the City. <br />Officer.R,otliy retired on April 30"', 2020.��.._..�.. <br />For ("lian e Orders Only <br />❑ Increase <br />❑ Decrease <br />$ <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Time Extension Amount: <br />New Completion Date: <br />Increase <br />% <br />Decrease <br />� <br />...............mm..%° <br />Increase <br />/o <br />Decrease <br />