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Home My WebLink AboutQPA Proposal - Gametime - New Surface at Potawatomi Park Playground1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND. INDIANA 46601-1830 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS February 14, 2017 Donald King Gametime c/o Sinclair Recreation PO Box 1409 Holland, MI 49422-1409 RE: QPA Proposal Dear Mr. King: PHONE 574/235-9251 FAX 574/235-9171 The Board of Public Works, at its meeting held on February 14, 2017, approved the above referenced proposal to remove the old damaged rubber surface and install new GT-hnpex play surface at Potawatomi Park Playground in the amount of $141,350.50. Enclosed please find a copy of the proposal for your records. If you have any further questions regarding this matter, please call this office at (574) 235- 9251. Sincerely, Linda M. Martin, Clerk Enclosure c: John Martinez, Parks Nick Gaul, Parks GARY A. GILOT $UZANNA M. FRITZBERG ELIZABETH A. MARADIK JAws A. MUELLER THERESE J. DoRAu CITY OF SOUTH BEND PURCHASE ORDER N PB53 Parks and Recreation The above order number must 321 E. Walter Street, South Bend, IN 46614- PH.(574)-299-4765 appearon all invoices, claims, The City of South Bend is an Equal Opportunity Employer packages, delivery slips, and correspondence TO: Gametime SHIPTO: 1020 High 1. If vendor delivers any merchandise without valid purhase order, no liability exists for City LOCATION Potti Playground of South Bend ASSET Surfacing 2. City of South Bend reserves the right to cancel all or part of this order if delivery is not PROJECT NAME Potts Surfacing made when and as acceptance. REQUESTED BY Ngaul APPROVED BY US Communities 3. Vendor accepts this order at listed price or lowest prevailing market price. No price -, Increase allowed after accptance I4. All goods subject to Inspection and rejection (freight at vendor's expense), not withstanding prior payments to secure cash discount. 5. If subject to cash discount, please Indicate on Invoice or claim. 1 Federal Excise Tax Exemption Indlana Sales Tax Exemption 0003502538-001 REOUISITION DATE 1/31/2017 35-6001201 ITEM It QUANTITY ITEMS AND DESCRIPTION PRICE TOTAL 1 removal of old surfacing 1 Security fencing anround project 1 Installation of new pour in place surfacing $31,121.00 $31,121.00 $3,392.00 $3,392.00 $106,837.50 $106,837.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL PURCHASE AMOUNT $141,350.50 CG—D—Mew,—MO n pLA (CORE C.P,,,, City of South Bend Attn: Nick Gaul 12 Floor City/County Bldg 227 West Jefferson Blvd South Bend, IN 46601 Phone:574-235-5597 ngaul@southbendin.gov GameTime c/o Sinclair Recreation PO Box 1409 Holland, MI 49422-1409 Ph:800-444-4954 Fax:616-392-8634 Potawatomie Park - 2017 Pricing PIP QUOTE #66952 01/30/2017 Project #: P56377 Ship To Zip: 46601 1 INSTALL Installation - Removal and Disposal of all old $31,121.00 $31,121.00 rubber and provide and install 21 as crushed stone / concrete compacted subbase of various thickness not less than 6" 1 INSTALL Installation - Add for Security on Site while $3,392.00 $3,392.00 material cures and Site Restoration 9250 GTPIP GT-Impax - SF 50/50 Blend Poured in Place $11.55 $106,837.50 2.5" thick for a 6' CFH - Installed - There would be a $25,251.30 upcharge to go up to a 100% color for the PIP. Sinclair P ecreation agrees to a $150/day liquidated damages penalty by SubTotal: $141,350.50 not completing by May 20's. Total Amount: $141,350.50 The Park will be under construction for 4-6 weeks, and unusable by the community during that time. Includes site cleanup, but not site restoration of grass, etc. THIS QUOTATION IS SUBJECT TO POLICES IN THE CURRENT GAMETIME PARK AND PLAYGROUND CATALOG AND THE FOLLOWING TERMS AND CONDITIONS. OUR QUOTATION IS BASED ON SHIPMENT OF ALL ITEMS AT ONE TIME TO A SINGLE DESTINATION, UNLESS NOTED, AND CHANGES ARE SUBJECT TO PRICE ADJUSTMENT. PURCHASES IN EXCESS OF $1,000.00 TO BE SUPPORTED BY YOUR WRITTEN PURCHASE ORDER MADE OUT TO GAMETIME, C/O SINCLAIR RECREATION. Pricing: f.o.b. factory, fine for 30 days from date of quotation. Sales Tax will be added at time of invoicing unless a tax exempt certificate is provided at the time of order entry. Payment terms: Net 30 days for tax supported governmental agencies. A 1.5% per month finance charge will be imposed on all past due accounts. Equipment shall be invoiced separately from other services and shall be payable in advance of those services and project completion. Retainage not accepted. Shipment: Order shall ship within 30-45 days after GameTime's receipt and acceptance of your purchase order, color selections, approved submittals, and receipt of deposit, if required. Installation: Shall be by a Certified GameTime Installer. Customer shall be responsible for scheduling coordination and site preparation. Site should be level and permit installation equipment access. Purchaser shall be responsible for unknown conditions such as buried utilities, nee stumps, bedrock or any concealed materials or conditions that may result in additional labor or material costs. Payment terms for installation is Net 10 Days. Exclusions: Unless specifically included, this quotation excludes all site work and landscaping; removal of existing equipment; acceptance of equipment and off-loading; storage of goods prior to installation; equipment assembly and installation; safety surfacing; borders and drainage provisions. Page 1 of 2 CG0M—dT-1M—e)o n JnLA}'CORE c"wv Acceptance of quotation: Proposed By Richard Sinclair: Accepted By (printed): N i < Signature: n_T'.1-�C k j- Title: FQCI I d. Facsimilie: 4 GameTime c/o Sinclair Recreation PO Box 1409 Holland, MI 49422-1409 Ph:800-444-4954 Fax:616-392-8634 Potawatomie Park - 2017 Pricing PIP ApPlonp Board of Public Works J 3► _► $141,350.50 QUOTE #66952 01/30/2017 Order Information:__ y� ;� Bill To: \% �p1%i ��+2 /.Iti1 `ma`s PAO Y-S + Ap,- S) Ship To: V FAyCtims . ' kR,<S d- AC'e� ) Contact: IV)('. 'l71 RM 1 Contact: �1C G A� Address: I b A0 11°1 Address: ) OAT> �4 1 j h Address: City, State, Zip: ` )c),w'�. NGI = nl `t Tel: J_l y '- �3''�5 C1 Address: City, State, ziipf: `�dN`i� ReJ �N l &60 Tel: -I l -a3s SALES TAX EXEMPTION CERTIFICATE #: 00 O 31 Z7—i 7 1 OO 1 (PLEASE PROVIDE A COPY OF CERTIFICATE) Tend tnn boG?,(A u P?Ro uci 1 in Pe-buzw,� Page 2 of 2 F lipm ST I05 Indiana Department of Revenue Stile Fomt4e1165 R4I8-05 General Sales Tax Exemption Certificate Indiana registered retail merchant I%unit businesses located oil [Side Iruliana may use (his certificate. Tie claimed exemption must be allowed by Iuliamr code. f3xcmption sluttas of other stales are not valid for purchases from Indian([ vendors. This exemption certificate can not be issued for the purchase of Ulililies, Whiclec, I9r re •errs r, or An crn f Purchaser must be registered with the Depot anent ref Revenue or the appropriate basing owhority of the purchaser's suite of residence. Sales Ins must be charged unless !it-[ Information in each section is fully completed by the pmrcl asen Purchasers not able to provide all required infurntalirm must pay (he lax tad may rile it claim for refund (Form GA.I I OL) dhrctly with the Department of Revonme. Name of Purchaser City of South Bend ness Address 227. W Jefferson Blvd Ctly South Bend Slate IN hoser trust provide tininuun of one 1D another bdow.e ide your Indiana Registered Retail Merchant's Certificate 0003122131 and LOC Number os shown on your Cwiilicale ............ .................•. TIDN On dulls) If noungistered with the Indiana DOR, provide your Slue Tax IDNumber from :mother State ............................................... •.......,,.... •.. *-See instructions on the reverse side if you do not have either number, Slate )])it ate. Is (his a 0 blanket purchase exemption request or a ❑single purchase exemption regueO (check one) 0 Description cal items to be purchased. Purchaser toast indicate the type of exemption facing claitucd for this purchase. (cheek one nr explain) ] Sales In a relailer, who)csoler, at, manufacturer for resale only. :1 Sale of manufacturing machinery. mots, unit equipment to be used directly in direct production, a Sales to nonprofit organizations claiming exemption pursuant to Sales Tax Information Bulletin #10. (May not he used for persomd hotel reams and teals.) Zip 46601 001 LOCP 13 digik) Stile of Isere Sales or totgible personal properly predominately used (greater (bell 50 percent) In providing public transportation - provide USDOTtI A person nr corporation who is hauling antler someone else s motor can9cr authority. or has a contract as a school has operator, must provide their SSO or FIDH in Kett of n Stale IDfk in Section ill • USDOTN Stiles to pelsous, occupationally engaged as fornlas, to be used directly in production orngricttlturnl product, for %;de. Note: A Tumor not possessing at Slate Business Licetseft any enter it FIDII or it SS# iu lieu of a Slatc ID4 in Section it 1, Stairs to a contractor for excnnpt projects (such as public schools, guvernmcn4 or nonprofits). Sales to Indiana Coveramental Units (agencies, cities, lowns, municipalil ics, public schools. tad slate universities) Shies ionic United.Stntcs Federal GoVornment-showageucy name, -- Note: A U.S. Government agency should cater its Federal Identification Number tP1Dfi) in Section III in lieu all a Slate ID/t. Otlier - explain. Vim 1 hereby certify under lire penullics of perjuy that file properly ptteclmsed by the use of this exemption certificate Is to be used for all exempt purpose pursuant m the State Gross Retail Sules'fax Act. Indiana Code 6-25, laid the item purchased is nil a utility, vehicle, woercrtdl, or uil'crn0. ��i wnfinn my nnderstuntling that misuse (rit/ernegfigrnr nr lnrrnrinn<d), and/or frnutlulem axe of this rrrtificate may subjnl both me pclsnnnily mud/or the business corky I rc +r snot to the ["Past Oil of us, interest. unit civil anthill criminal pcutdlies. Signn(ureol•Purchaser 4-X116r;." ' 'T.�t1.� Date 1/5/2015 Prined None Sh�nnon Fredline Till, AP Supervisor The Indiana Depnrtment of Revenue only request verification of re&istmtion it, another state Irvin are an oul-or-same purchasm Seller musthctp ibis certificate on rile tosupport exempt sales. GameTime Contract I U.S. Communities Page 1 of 1 Solutions BY SUPPLIER Oh.ali->) BYCATEGORY Facilities Office & School Specialty Technology Main Menu JUMPTO: Solicitations About News & Events Resources Solutions Contact Us Shop Education Purchasing Government Purchasing Nonprofit Housing Authorities Go Green Program Innovation Exchange About News & Events Resources Contact Us PRODUCTS & SOI.UTIONS CONTRACT DOCUMENTS SHOP gGism LOGIN GameTime Contract Home Oameylme s QameTime Conic Park and Playground Contract Documents: Lead Agency: I City of Charlotte/Mecklenburg County, North Carolina Contract No.110179 Contract Attachment Contract Number: Contract Amendments 110179 5 year initial term, September 17, 2010 to September 16, 2015 Contract has been extended through September 16, 2017 RFP Documents: Request For Proposal RFP269-2010-183 Amendments RFP-IS-10255020 Posting Postings Documents Nine suppliers responded to the solicitation process; posted on various Internet sites Posting Information: Date Posted: U.S. Communities: Upcoming Contract Association of Oregon Counties March 22, 2010 to April 22, 2010 State of North Carolina Interactive Purchasing March 22, 2010 to April 22, 2010 System Canadian MERX Public Tenders March 22, 2010 to April 22, 2010 Onvia Demand Star March 22, 2010 to April 22, 2010 State of Hawaii and Oregon March 22, 2010 to April 22, 2010 U.S. COMMUNITIES 1NATIONAL COOPERATIVE PURCHASING PROGRAM Getting Started Why Use U.S. communities Discounts on Brands over 55,000 agencies trust U.S. • Program Overview What Makes Us Different Products & Suppliers Who Uses U.S. Communities? • Howit Works Webinars&Events Online Marketplace Cooperative Standards • FAQs Supplier Commitments Solicitations State Statutes CONTACTUS BECOMEASUPPLIER ABOUTUS LEGAL PRIVACY MICPA 0 covi U.S. CummmjRlss I At Rights Reined. http://www.uscommunities.org/suppliers/gametime/gametime-contract/ 10/17/2016 EXHIBIT A Contract Pricing and Discount Structures The attached Pricing Sheets is incorporated into and made a part of the Agreement to provide Playground Equipment, Surfacing, Site Furnishings, and Related Products and Services (the "Agreement') between Mecklenburg County, (the "County") and PlayCore-Wisconsin, Inc. dba GameTime (the "Company"). Unless otherwise defined herein, capitalized terms in this Exhibit shall have the same meanings as are assigned to such terms in the RFP. 15 Ga`rrieTime° Enriching Childhood Through Play. GameTime Division PlayCore Wisconsin, Inc. 150 PlayCore Drive, S.E. Fort Payne, Alabama 35967 Telephone: 2 5 6/84 5-5610 Facsimile: 256/845-9361 REQUEST FOR PROPOSAL #269-2010-183 PRICING SCHEDULES Accompanying Pricing Schedules: 1. GameTime Year One U.S. Communities Contract Net Price List 2. Snug Year One U. S. Communities Contract Net Price List 3. GTlmpax Year One U.S. Communities Contract Net Price List 4. Ultra Play Year One U. S. Communities Contract Net Price List 5. GT Grandstands Year One U.S. Communities Contract Net Price List 6. RCP Shelters Price List RCP402524015 7. GTH2O Year One U.S. Communities Contract Net Price List 8. Everlast Year One U. S. Communities Contract Net Price List 9. Spohn Ranch U.S. Communities Year One Budget Pricing 10. Recreation Equipment Manufacturing Year One U. S. Communities Contract Net Price List 11. GameTime Year One U.S. Communities Discounts and Installation charges GameTime Discounts: a. Equipment (including components): Freestanding Events: Snug Early Childhood Play Equipment: PlayWorx GFRC ThemeScapes: b. Surfacing: c. Site Furnishing: d. Related Products Fitness and Sports: GTShade Structures and Shelters: GTH2O Water Slides: GTH2O Spray Grounds: GTNets Climbing Nets: Everlast Indoor Climbing Walls: NatureROCKS Climbing Boulders: Shelters: 24% (see Quantity Discounts below) 16% 6% 6% 18% 6% 6% 9% 4% 3% 3% 3% 10% 5% 4% 5/5/2010 RFP 269-2010-183 Page 10-1 PRICING SCHEDULES Dog Parks: Skate Parks: Drinking Fountains: e. Services: Playground Equipment Installation Safety Surfacing Installation Sitework Services 6% 6% 5% All Services Net Pricing Community Build Supervision Design Services Maintenance and Repairs CPS] Initial Playground Safety Audit CPSI Low -Frequency Playground Safety Inspection CPS[ Maintenance and Inspection Training (Quotations on a case -by -case basis) Volume Discounts: Volume single purchases of composite play systems at U.S. Communities net pricing shall be eligible for an additional discount of 5% for orders totaling from $50,000 to $75,000; 10% from $75,000 to $100,000 and 15% for orders exceeding $100,000. Cash With Order Discount Orders for playground equipment paid for at the time of placement are entitled to a 3% cash - with -order discount. Product, Design and Price Comparison for Sample Playground Designs: See Proposed Solutions, Tab 15 Installation Fees See accompanying GameTime Year One U.S. Communities Discounts and Installation charges Shipping and Delivery— Shipping Program Shipments shall be f.o.b. destination with freight charges prepaid and listed separately. Actual freight charges shall be added at time of invoicing as determined and supported by the carrier's Freight Bill. Estimated freight charges shall be provided at time of quotation utilizing the accompanying freight rate schedules. Price Adiustments Pricing shall remain in effect until December 31, 2011. Thereafter, GameTime pricing shall be adjusted the first of each year with the printing and distribution of the company's annual product catalogs. 5/5/2010 RFP 269-2010-183 Page 10-2 C66 Enriching Childhood Through Play. Date: March 5, 2010 GameTime Division of PlayCore-Wisconsin, Inc. 150 PlayCore Drive, SE Fort Payne, AL 35967 Telephone: (256) 997-5255 Facsimile: (256) 997-5455 Contact: Don King E-mail: dking@gametime.com GAMETIME PROPOSAL Charlotte Mecklenburg Procurement Services Project: RFP 269-2010-183 Government Center, g1h Floor Attention: Karen Ruppe 600 East Fourth Street Telephone: 704/336-2992 Charlotte, NC 28202 E-mail: kruppe@charlotte.gov We are pleased to submit our proposal to furnish GameTime products and services in accordance with the provisions and terms of RFP 269-2010-183 and as described herein. Enclosed are our design proposals, bid forms, price lists, discount schedule, product descriptions, material specifications, company qualifications and other data called for under this solicitation. This proposal is subject to policies published in the 2010 GameTime Playground Design Guide and the following terms and conditions. Pricing: shall be net, f.o.b. destination with freight charges prepaid, added and listed separately. Actual freight charges shall be added at time of invoicing as determined and supported by the carrier's Freight Bill. Estimated freight charges shall be provided at time of quotation utilizing the accompanying freight rate schedules. GameTime offers most favored pricing and special discounts to those local public agencies participating in the U.S. Communities contract. Pricing shall remain in effect until December 31, 2011 and is subject to the applicable discounts stated herein. GameTime pricing shall be adjusted the first of each year with the printing and distribution of the company's annual product catalogs. Volume Discounts: volume single purchases of composite play systems at U.S. Communities net pricing shall be eligible for an additional discount of 5% for orders totaling from $50,000 to $75,000; 10% from $75,000 to $100,000 and 15% for orders exceeding $100,000. Orders: All orders shall be in writing on the buying entity's purchase order form or similar documentation. Open buying on the internet (OBI) is not currently available. Shipment: shall be f.o.b. destination and commence within 3 - 4 weeks after our receipt and acceptance of the customer purchase order, color selections and approval of submittals, if required. Terms of Sale: payment is due within 30 days from date of invoice for governmental agencies. Payments may be made by VISA, MasterCard or American Express. Orders for playground equipment paid for at the time of placement are entitled to a 3% cash -with -order discount. Minimum Order: RFP 269-2010-183 purchases, other than replacement parts, require a minimum order of $500.00. Date: May 5, 2010 Project: RFP 269-2010-183 Packaging: all goods shall be packaged in accordance with acceptable commercial practices and marked to preclude confusion during unloading and handling. Receipt of goods: customer shall receive, unload and inspect goods upon arrival, reporting any discrepancies on the Delivery Receipt prior to written acceptance of the shipment. Installation: if included with purchase, shall be by a Certified GameTime Installer. Customer shall be responsible for scheduling coordination and site preparation. Site should be level and permit installation equipment access. Purchaser shall be responsible for unknown conditions such as buried utilities, tree stumps, bedrock or any concealed materials or conditions that may result in additional labor or material costs. Exclusions: this proposal excludes all site work and landscaping; removal of existing equipment; storage of goods prior to installation; drainage provisions; and safety surfacing borders unless purchased separately. Customer shall be responsible for providing a clear, level site for installation and for scheduling deliveries and coordinating installation. Submittals: If required, GameTime shall submit for review and approval by the owner's representative detailed drawings depicting the equipment to be furnished accompanied by specifications describing materials. Once approved, these drawings and specifications shall constitute the final documents for the project and shall take precedence over all other requirements. GameTime shall provide for each playground two sets of installation, assembly and maintenance instructions in accordance with our standard practices. All composite playground designs and equipment shall comply with the current version of ASTM F 1487, Standard Consumer Safety Performance Specification for Playground Equipment for Public Use; Handbook for Public Playground Safety Publication 325 by the U.S. Consumer Product Safety Commission; and the Guide to ADA Accessibility Guidelines for Play Areas published by the U.S. Access Board. GAMETIME Donald R. King Director of Sales Administration Nick Gaul From: Doug Looney <dlooney@uscommunities.org> Sent: Monday, October 10, 2016 1:17 PM To: Sarah Florkowski Cc: Nick Gaul; George King Subject: RE: SAMPLE OF QPA E-Mail For Your Approval Importance: High Hello, Sarah. The information you need can be found via the link below and if you need anything else, please let me 3 know. In regards to other using agencies, we have over 2,097 registered agencies throughout the State. Indy Parks, Peru Schools, City of Kendallville and Elkhart Community Schools are a few that used this contract recently. http://www.uscommunities.or /g_suppliers/gametime/gametime-contract/ Best regards, Doug Looney National Program Director- North Office: (866) 472-7467 x 249 1 Mobile: (314) 210-8058 dloonev@uscommunities.ora . Just launched! New Technology Solutions — Find Out More! Notice to recipient: This e-mail is only meant for the intended recipient of the transmission, and may be a confidential communication or a communication privileged by law. If you received this e-mail in error, any review, use, dissemination, distribution, or copying of this e-mail is strictly prohibited. Please notify us Immediately of the error by return e-mail and please delete this message from your system. Thank you in advance for your cooperation. From: Sarah Florkowski[mailto:sflorkow@southbendin.gov] Sent: Thursday, October 06, 2016 2:09 PM To: Doug Looney <dlooney@uscommunities.org> Cc: Nick Gaul <ngaul@southbendin.gov>; George King <gking@southbendin.gov> Subject: SAMPLE OF QPA E-Mail For Your Approval Good Morning Doug, The City of South Bend Park Department would like move forward with a QPA for US Communities. We intend to use Gametime to install surfacing under the playground equipment at Potawatomi Park located at 500 S. Greenlawn Ave. We need to have the following questions answered: a. Where was it advertised? When and how often. b. What was the award criteria? c. What Indiana Municipality has used the agreement? Thank You, Nick Gaul From: George King Sent: Tuesday, June 14, 2016 9:02 AM To: Nick Gaul Subject: QPA Questions Attachments: Mike Grade - TCPN Nick, To qualify that they bid the agreement correctly, ask TCPN (Mike Grade) the following questions; 1. How was this advertised? If in newspapers, which ones and how often. 2. What was the award criteria? Low bid or on a scale? 3. Are there any municipalities in Indiana that have used this contract in the past year? And last, Mike Grade's contact info is attached. Once you get the answers to 1,2, and 3. Share them with Michael Schmidt and me. We will give you the approval to move ahead with the purchase. Geoeqe King Administration and Finance City of South Bend 227 West Jefferson Blvd. South Bend, IN 46601 gking@southbendin.gov 574-235-9977 Memo To: The Board of Public Works From: John Martinez, VPA George King, Purchasing, Admin. & Finance cc: Nick Gaul, Facilities Manager, VPA Date: February 7, 2017 Re: Potawatomi Playground Surfacing Bid Approval I ask the board to please approve the awarding of the Potawatomi Playground Surfacing Installation to Gametime c/o Sinclair Recreations. We would be using a previously established QPA whose criteria we find to be fulfilled and attached for your review. Thank You, John Martinez Director, Facilities & Grounds Division South Bend Venues Parks & Arts 1020 High St. South Bend, IN 46614 Off ice: (574) 235-7645 Fax: (574) 235-5540 CITY OF SOUTH BEND VENUES PARKS 8 ARTS BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 217/17 Department Name John Martinez Venues, Parks, & Arts BPW Date 2/14117 Phone Extension 235-7645 Legal Attorney Name Michael Schmidt Controller review is required for all Contracts $5,000.00 or more Controller ❑ and greater than one year in length per the City Purchasing Policy Purchasing ® George King Check the Appropriate Item Type — Required for All Submissions ❑ Agreement ❑ Contract ❑ Proposal ❑ Addendum ❑ Professional Services ❑ Bid Opening - Bid Award ❑ Req. to Advertise ❑ Title Sheet ❑ Quote Opening ❑ Quote Award ❑ Chg Order No. ❑ C/O & PCA No. ❑ PCA Ease./Encroach. ❑ Traffic Control ❑ Resolution Other:(9P$Rasrepo-,-A F ❑ Claim Reauired Information Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description Amount of Gametime ❑ Yes ® No ❑ MBE F- WBE Park Bond 41 If Yes, Approved by Purchasing Completed E-Verify Form Attached Install ❑ Yes ❑ No To remove the old damaged rubber surfacing and install new GT- Impex play surfacing under our All Access Playground on site. For Chanqe Orders Onlv Increase Decrease Previous Amount Current Percent of Change: New Amount Total Percent of Change: Time Extension: Dispersal After Approval Copy Original ❑ ❑ ❑ ❑ ❑ ❑