HomeMy WebLinkAboutWORK ORDER - PURCHASE ORDER - 9132121EXHIBIT "A"
WORK ORDER FORM
PURSUANT TO AN AGREEMENT BETWEEN
THE CITY OF FORT COLLINS
AND
CGRS, INC.
DATED: 4/18/2013
Work Order Number. Orphan UST001
Purchase Order Number: 2
Project Title: Orphan UST site investigation
Commencement Date:
Completion Date:
IR FP � -7-z13 46
Maximum Fee: (time and reimbursable direct costs):$11,000
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Project Description: perform a site investigation to evaluate the nature and extent of petroleum
hydrocarbon impacts to soil and groundwater beneath an orphan UST that was removed from Pine and Jefferson
Scope of Services: See attached proposal
Professional agrees to perform the services
identified above and on the attached forms in
accordance with the terms and conditions
contained herein and in the Professional Services
Agreement between the parties. In the event of a
conflict between or ambiguity in the terms of the
Professional Services Agreement and this work
order (including the attached forms) the
Professional Services Agreement shall control.
The attached forms consisting of Exhibits _, _,
consisting of _ U pages are hereby accepted
and incorporated herein, by this reference, and
Notice to Proceed is hereby given.
Profesgional:
By:
Date: it 1 iJ
City of Fort Collins
Submitted By:
Project Manag r
Date: 19
Reviewed b
is a ement
Date: —! —/ 3
Approved by:
Dater
Approved by:
Date:
Approved by:
Director of Purchasing & Risk Management
(if over $60,000.)
Date:
PC, -�f �?/3 212
Req. #
Entered by:
Date:
PURCHASE ORDER REQUISITION
FORT COLLINS UTILITIES
Vendor CGRS. Inc
V
Address 1301 Academy Court
Fort Collins, CO 80524
QTY. DESCRIPTION UNIT TOTAL CHARGE NUMBER
Site investigation to evaluate the $11,000 506071-521210
nature and extent of petroleum
hydrocarbon impacts to soil and
groundwater beneath a removed
orphan UST
Comments
Errin Henggeler April 18,2013
Requested By Date
Authorized By
Date