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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />BPW Date <br />10/16/2012 <br />10/18/2012 <br />Name Pam Paluszewski <br />Department Legal <br />Phone 5865 <br />Legal E Attorney Name Cheryl Greene <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller ❑ and greater than one year in length per the City Purchasing <br />Policy <br />Purchasing E] <br />A reement <br />Contract <br />❑ Pro o—sal <br />I El Addendum <br />Claim <br />F1 <br />El <br />Bid Opening <br />Quote Openin <br />❑Bid Award ❑ Req. to Advertise ❑Title Sheet <br />D Quote Award <br />0 <br />Chg Order No. <br />PCA No. <br />❑ PCA <br />I❑I <br />Ease./Encroach. <br />❑ Traffic Control <br />❑ Resolution <br />7T—Other: <br />Company or Vendor Name <br />New Vendor <br />Yes <br />E] If Yes, Approved by Purchasin <br />MBE/WBE Contractor <br />L MBE Ej WBE <br />Project Name <br />Special Victims Unit Service Exchange Agreement with St. <br />Joseph County <br />Project Number <br />Funding Source <br />Project Fund <br />Account No.. <br />Amount <br />$ <br />Terms of Contract <br />5 year agreement na $40' er year <br />Purpose/Description To provide funds for the housing and operation of the SVU in <br />South Bend <br />A <br />Amount of ❑ Increase $ <br />❑ Decrease 1z <br />Previous Amount <br />$ <br />Current Percent of Chan e: <br />% <br />New Amount <br />$ <br />Total Percent of Change: <br />% <br />PO No. <br />Dispersal After Approval <br />Copy Original <br />El N BPW and St. Joseph County Prosecutor (2 originals) <br />® 5 Legal <br />