Award Bid Extension - One or More 2018 or Newer Emergency Medical Vehicle Spec S - Horton Emergency Vehicle

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BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date March 18, 2019 Name Jeff Hudak ....... .. Department Fire Department BPW Date March 26, 2019 Phone Extension 574-235-9316 �. it MIIimmmmmmomummimmmmmmmuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuumm raw; ;r r�rvi�i cnw wuua�.uw�,aF uflra - __ .... ... .�,..A„m „n ,,.m,,,,m,..,..�,..�........ Required Pnor to Submittal to Board mmmm Legal Attorney Name Clara McDaniels Controller Controller review is required for all Contracts $5,000.00 or more and greater than one year in length per the City Purchasing Policy Purchasing Michael Schmidt Check the LJ Agreement 0 Professional Services E] Bid Opening Quote Opening Change Order No. Ease/Encroach. Other: Company or Vendor Name New Vendor MBE/WBE Contractor MBE/WBE Contractor Requested Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description �ror�atew Item T Contract Resolution El Bid Award El Quote Award ❑ C/O & PCA No. _ ❑ Traffic Control d for All Submissions �] Proposal ® Req. to Advertise ❑ PCA Required Information Horton Emergency Vehicles El� Yes No El If Yes, Approved by Purchasi R MBE R WBE Addendum ❑ Title Sheet ❑ No ❑ Yes Name ofwCompany ................... _.�.............._ Spec S - Extension One (1) or more 2018 or newer emergency medical vehicle Fire Department CgitalB,udget 287-0902-421.43-02..... One more or less 2018 or newer Emergency Medical Vehicle ❑ Required Contractor's Certification Form Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verif, Iran, etc. Amount of De increa ase e $ Previous Amount $ Current Percent of Change: % New Amount $ Total Percent of Change: % ...... .................Dispersal After�Amm..._.....r......ov..... ppal Copy Original ® ❑ Jeff Hudak ® ❑ To..�...�._....._.. ... ��_.........._........................� d Skwarcan R ❑ .. ........ ... .- .... m, �...�.�.