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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date July 8, 2025 <br />Department Central <br />Name Adam Cole Services <br />BPW Date July 22, 2025 Phone Extension <br />Review and Approval Required Prior to Submittal to Board <br />Diversity Compliance ❑ <br />Officer Name <br />and Inclusion Officer <br />BPW Attorney <br />❑ Attorney Name <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 />n Other: n Ease./Encroach <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 />Information <br />U Yes U If Yes, Approved by Purchasing <br />❑ No <br />E] MBE ❑ WBE Completed E-Verify Form Attached ❑❑ Neos <br />Spec C — Seven (7) More or Less 2025 or Newer 3/4 Ton Four Wheel Drive <br />Pick Un Trucks <br />PR42013/Golf, PR42010/OR, PR42011/Streets, PR42012/Water, <br />PR42014/Park Proiects <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />Amount of ❑ Increase $ 1*1�4 <br />❑ Decrease <br />Previous Amount $ Elizabeth A. Maradik, President <br />Current Percent of Change: <br />New Amount <br />Total Percent of Change: <br />Increase <br />Decrease <br />S <br />Increase <br />Decrease <br />Gary A. Gilot, Member <br />.4 7'-A�-' <br />Murray L. Miller, Member <br />Joseph R. Molnar, Vice President <br />Breana Micou, Member <br />Attest: Madeline Hostetler, Acting Clerk <br />Date: July 22, 2025 <br />