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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date <br />Name <br />H115E5R <br />Chief Lancaster <br />Department SBPD <br />BPW Date 01-22-19 Phone Extension 9301 <br />': H�'�SEY�1i '' II!T,R.,.M$1JN WIWI�I�NIW Nf�WUA <br />�n ,� ............. Re al o Board <br />Prior to Submittal t <br />........ ...._..... . <br />Legal ® Attorney Name Clara McDaniels <br />Controller Controller review is required for all Contracts $5,000.00 or more anc <br />greater than one year in length per the City Purchasing Policy <br />Purchasing 1-1 <br />Check the Appropriate Item Type <br />LJ Agreement <br />❑ Professional Services <br />E] Bid Opening <br />El Quote Opening <br />El Change Order No. _ <br />El Ease/Encroach. <br />E] Other: <br />Company or Vendor Name <br />H Contract <br />Resolution 3 .,2 a r 9 <br />El Bid Award <br />E Quote Award <br />❑ C/O & PCA No. <br />❑ Traffic Control <br />for All Submissions mm <br />] Proposal [::I Addendum <br />E] Req. to Advertise ❑ Title Sheet <br />uired Information <br />❑ PCA <br />New Vendor Yes ❑ No ❑ If Yes, Approved by Purchasing <br />MBE/WBE Contractor ❑ MBE R WBE <br />MBE/WBE Contractor Requested ❑ No E] Yes Name of Company <br />Project Name Retirement gift of firearm to Barry Mead <br />Project Number <br />_...._......_._ ......... <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Purpose/Description <br />The South Bend Police Dept. reauests that the Board of Public <br />Works declare Officer Bar Mead's Smith & Wesson M&P9 <br />handgun as surplus property no longer useful to the city. Serial No <br />HKB3620.This declaration will authorize the presentation of the <br />above listed firearm as a tribute for his gears of service to the City. <br />Retired: 01 /05/19 2 Lr <br />❑l Required Contractor's Certification Form Attached (Non - <br />Collusion„ Non -Discrimination,, Non -Debarment, E-Verify, Iran,. etc.) <br />R uIred For Change Orders Only <br />Amount of El Increase $ <br />E] Decrease $ <br />Previous Amount $ <br />Current Percent of Change: % <br />New Amount <br />Total Percent of Change: % <br />Dispersal After Approval <br />Copy Original <br />® ❑ Chief Lancaster <br />