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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: September 14, 2020 <br />Department of Public Works –Engineering Division <br />Name: Finnian Cavanaugh <br />Phone Extension: 5961 or <br />BPW Date:September 22,2020fcavanau@southbendin.gov <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney NameClara McDaniels <br />Dept. Attorney Attorney Name <br /> <br />Purchasing <br />Check the Appropriate Item Type –Required for All Submissions <br /> Professional Services Agreement Contract Proposal <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 No. PCA <br /> Chg. Order, No. Traffic Control Resolution <br /> Other: Ease./Encroach <br />Required Information <br />Company or Vendor NameN/A <br /> Yes If Yes, Approved by Purchasing <br />New Vendor <br /> No <br /> MBEYes <br />MBE/WBE Contractor Completed E-Verify Form Attached <br /> WBE No <br />Project Name Triumph Court Lighting Addition <br />Project Number 120-006E <br />Funding SourceLight Up South Bend <br />Account No. 404-06-600-500-422018-06LUSB- <br />AmountTBD <br />Terms of ContractNTE <br />Purpose/DescriptionRequest to reject quotes submitted at Sept. 8 BPW meeting –quotes <br />exceed project budget <br /> <br /> <br />For Change Orders Only <br />$ <br /> Increase <br />Amount of <br />Decrease ($ ) <br />Previous Amount $ <br /> % <br />Increase <br />Decrease ( %) <br />Current Percent of Change: <br /> <br />New Amount$ <br /> % <br />Increase <br />Decrease ( %) <br />Total Percent of Change: <br /> <br />Time ExtensionAmount: <br />New Completion Date: <br /> <br />