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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 8/14/18 <br />Name <br />LorV Timmer <br />Department <br />DCI <br />�BPW Date <br />8/28/18 ---------- <br />Phone Extension <br />. . . .... <br />...... .. 5841 <br />Legal <br />Controller <br />Purchasing <br />Che, <br />Agreement <br />F-1 Professional Services <br />Bid Opening, <br />❑ Quote Opening <br />F-1 Change Order No, <br />n Ease/Encroach. <br />n Other: Amendment <br />Attorney Name Clara McDaniels <br />Controller review is required for all Contracts $5,000.00 or more and <br />greater than one year in length per the City Purchasing Policy <br />Contract <br />F-1 Resolution <br />F1 Bid Award <br />Ell, Quote Award <br />❑ C/O & PCA No. <br />❑ Traffic Control <br />Proposal <br />0 Req. to Advertise <br />um <br />Company or Vendor Name South BendHeritage Foundation <br />New Vendor [:] Yes M No [:] If Yes, Approved by Purchasing <br />MIBE/WBE Contractor F-1 MBE [:] WBE <br />MBEIWBE Contractor Requested M No F-1 Yes Name of Company <br />Project Name CDBG Activity Delivery <br />Project Number 18-JC-1 5 <br />Funding Source Community Development Block Grant (CDBP) <br />Account No. 2.12,1001.460.39.30 . .............. . . <br />Amount $100,000 <br />Addendum <br />[I Title Sheet <br />Terms of Contract 1/01/18 - 12/31/18 <br />Purpose/Description Subsidize staff costs for operating affordable housing prograin"S­ <br />M Required Contractor's Certification Form Attached (Non - <br />Collusion, Non -Discdmination, Non -Debarment, E-Verify, Iran, etc. <br />Amount of H Increase <br />[:1 Decrease <br />Previous Amount $ <br />Current Percent of Change.- — <br />New Amount $ <br />Total Percent of Change, <br />Dispersal After Approval <br />Copy <br />Original <br />E <br />[J Judy Love <br />.. .............. <br />F1 <br />F-1 <br />1-1 <br />0 <br />