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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 1/16/2018 <br />Name Danielle Fulmer Department Innovation & Tech <br />BPW Date 1/23/2018 Phone Extension 6018 <br />..-Required Prior tee Submittal to Board <br />Legal Attorney Name Benjamin Dougherty <br />Controller review is required for all Contracts $5,000.00 or more <br />Controller Z and greater than one year in length per the City Purchasing <br />Policy <br />Purchasing M <br />N <br />Agreement <br />LJ Contract <br />U1 Proposal LJ Addendum <br />Z <br />Professional Services <br />n Amendment <br />E] <br />Bid Opening <br />F] Bid Award <br />F-1 Req. to Advertise Ell Title Sheet <br />F-1 <br />Quote Opening <br />D Quote Award <br />[:1 <br />Chg Order No. <br />F-1 C/O & PCA No. <br />EJ PCA <br />F1 <br />Ease./Encroach.] <br />Traffic Control <br />El Resolution <br />Fl <br />Other: <br />F-1 Claim <br />Company or Vendor Name <br />ETC Institute <br />Z Yes E:1 If Yes, Approved Iby Purchasing <br />New Vendor <br />F-1 No, <br />[:] El Yes <br />MBE/WBE Contractor <br />Completed E-Verify Form Attached <br />FJ MBE Nos <br />Project Name <br />City Resident Survey <br />Project Number <br />N/A <br />Funding Source <br />Innovation & Technology <br />Account No. <br />279-0672-415-31-06 <br />Amount <br />$191,180.010 <br />Terms of Contract <br />Net 30 <br />Purpose/Description <br />ETC Institute works with mid -sized cities to administer surveys to <br />residents regarding satisfaction with city services and quality of <br />life. This oLganization offers survey design and sampling services <br />to ensure, that results are statistically valid, and provides <br />benchmark figures for a library of survey questions. The <br />Department of Innovation and Technology plans to work with <br />ETC Institute and City leaders to develop a survey that will <br />provide actionable feedback from the residents of South Bend <br />and that provides statistically significant results at 6"Council <br />District level. The results of the survey will be used to inform <br />performance management and continuous improvement proilects, <br />in collaboration with Citv departments. <br />Amount of H Increase $ <br />[] Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount <br />