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BOARD OF PUBLIC WORKS <br />AGENDA ITEM REVIEW REQUEST FORM <br />Date 8/16/2019 <br />Name Mark Q2LHa �cr Department SBPD <br />BPW Date 8/27/2019 Phone Extension 7677 <br />SO <br />� <br />lecf fired Prior to Submittal to Board <br />W Attorney Attorney Name Clara McDaniels <br />Dept. Attorney F<C Attorney Name Geovanny Martinez <br />Purchasing <br />.......... <br />Professional Services Agreement p�� Contract � w � � �� All Submissions <br />Check the A c )riate Item_ I° ua / r <br />......... ......_. ��� �... ..m.mm_... Proposal <br />El <br />❑ Open Market Contract 0 Amendment/Addendum ❑ Special Purchase, QPA <br />❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet <br />E] Quote Opening ❑ Quote Award ❑ Deject Bids/Quotes <br />E] Proposal Opening [] C/O & PCA No. E] PCA <br />El Chg. Order, No. ❑ Traffic Control Z Resolution aD 4 <br />Other: Ease./l ��c r�aac is <br />� ._ _......... _ _ _.........._. ......_._E.. n ... roac �.._�._ .........� _ �_ <br />Company or Vendor Name <br />New Vendor <br />MBE/WBE Contractor <br />Project Name <br />Project Number <br />Funding Source <br />Account No. <br />Amount <br />Terms of Contract <br />Required red Information <br />........... rwv.._....... _........ <br />❑ Yes❑ If Yes, Approved by Purchasing <br />❑ No <br />0 WBE Completed E-Verify Form Attached El Yes <br />El No <br />Retirement Gift of SBPD firearm to Stephanie Fox <br />Purpose/Description <br />The South Bend Police Department requests the Board declare Officer Stephanie <br />Fox's Smith & Wesson M&P9 handgun, serial 4NDT0123 as surplus property no <br />longer useful to the City. This declaration will authorize the presentation of the <br />above listed firearm as a tribute for her 21 years of service to the City. Officer Fox <br />retired on pS11st I3, 2019.mm <br />�w�a._...._ <br />For f�lta Ordersm°� <br />Amount of ❑------- <br />Increase $ <br />Decrease_Me <br />Previous Amount <br />.........................�� �._. �.���__ � <br />Increase % <br />�. <br />Current Percent of Change: <br />o �._ .e... .. <br />Decrease �_ /o m � _ ... <br />New Amount <br />$ _.._........_ _ .. _..... .. ......... — ....._ <br />Increase % <br />Total Percent of Change: <br />Decrease w% <br />Time Extension Amount: <br />New Completion Date <br />