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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date: 2/27/23 <br />Name: Jitin Kain Department of Public Works <br />BPW Date: 3/14/23 Phone Extension: 5835 <br />Required Prior to Submittal to Board <br />BPW Attorney X Attorney Name Michael Schmidt <br />Dept. Attorney ❑ Attorney Name <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 />F1 Other: License & Agreement n Ease./Encroach <br />Information <br />Company or Vendor Name Bird Rides, Inc. <br />New Vendor ❑ Yes❑ If Yes, Approved by Purchasing <br />❑ No <br />MBE/WBE Contractor ❑ WBE Completed E-Verify Form Attached ® Yes <br />No <br />Project Name Shared Mobility Program <br />Project Number <br />Funding Source <br />Account No. PR/PO # <br />Amount <br />Terms of Contract <br />Special Contract Provisions <br />Purpose/Description License renewal and two year agreement with Bird Rides, Inc. to operate e- <br />scooters and e-assist pedal bikes in South Bend. There is no cost to the City <br />to offer this license. <br />For Change Orders Only <br />Amount of ❑ Increase $ <br />❑ Decrease ($ ) <br />Previous Amount $ <br />Current Percent of Change <br />New Amount <br />Increase <br />Decrease <br />Increase <br />Total Percent of Change: Decrease <br />Time Extension Amount: <br />New Completion Date: <br />