HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 9185297Utilities Work Order – Construction Form Official Purchasing Form
Last updated 10/2017
FORT COLLINS UTILITIES
CONSTRUCTION WORK ORDER
2018 CURED IN PLACE PIPE
WORK ORDER NO. U1-09112018
CONTRACTOR: Granite Inliner
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DocuSign Envelope ID: 2A548F07-3BC8-4333-87ED-56922441772E
Utilities Work Order – Construction Form Official Purchasing Form
Last updated 10/2017
TABLE OF CONTENTS
AGREEMENT FORMS
00525 Work Order, Notice of Award & Bid Schedule
00530 Work Order Notice to Proceed
00600 Bonds and Certificates
00610 Performance Bond
00615 Payment Bond
00630 Certificate of Insurance
00635 Certificate of Substantial Completion
00640 Certificate of Final Acceptance
00650 Lien Waiver Release (CONTRACTOR)
00651 Lien Waiver Release (SUBCONTRACTOR)
00660 Consent of Surety
00670 Application for Exemption Certificate
00800 Supplementary Conditions
00900 Addenda, Modifications and Payment
00950 Work Order Change Order Form
00960 Application for Payment
ADDITIONAL DOCUMENTS
Attachment A DRAWING INDEX
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DocuSign Envelope ID: 2A548F07-3BC8-4333-87ED-56922441772E
Utilities Work Order – Construction Form Official Purchasing Form
Last updated 10/2017
SECTION 00500
CONSTRUCTION WORK ORDER AGREEMENT FORMS
00525 Work Order, Notice of Award & Bid Schedule
00530 Work Order Notice to Proceed
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DocuSign Envelope ID: 2A548F07-3BC8-4333-87ED-56922441772E
Utilities Work Order – Construction Form Official Purchasing Form
Last updated 10/2017
SECTION 00525
WORK ORDER, NOTICE OF AWARD AND BID SCHEDULE
TO: UGranite Inliner
WORK ORDER NUMBER: U1-09112018
PROJECT TITLE: U2018 CIPP
ORIGINAL BID/RFP NUMBER & NAME: U8123, Cured In Place for Sanitary Sewer /
Storm Water Mains Rehabilitation / Manhole
Rehabilitation
MASTER AGREEMENT EFFECTIVE DATE: UJuly 1, 2015
ARCHITECT/ENGINEER: UNA
OWNER’S REPRESENTATIVE: URay Fisher
WORK ORDER COMPLETION DATE: UDecember 2, 2018
MAXIMUM FEE: (time and reimbursable direct costs): $ U429,560.00
NOTICE OF AWARD DATE: USeptember 11, 2018
OWNER: UCity of Fort CollinsU (hereinafter referred to as OWNER)
1. WORK. Pursuant to your MASTER AGREEMENT with OWNER dated UJuly 1, 2015U, and
your Work Order Proposal dated UAugust 3, 2018,U you have been awarded a Work Order for
U2018 CIPPU.
PROJECT DESCRIPTION & SITE LOCATION: USee attached documentation.
2. CONTRACT PRICE, BONDS AND CERTIFICATES. The price of your Work Order is Ufour
hundred twenty-nine five hundred sixty thousand and zero centsU ($U429,560.00U). Pursuant to
the AGREEMENT and the Work Order Documents, Performance and Payment Bonds and
insurance are required.
3. CONTRACT TIMES. Pursuant to the MASTER AGREEMENT and the Work Order
Documents, the date for Substantial Completion of this Work Order is UNovember 2, 2018U,
and after Substantial Completion, the date for Final Completion is UDecember 2, 2018U.
4. LIQUIDATED DAMAGES. OWNER and CONTRACTOR recognize that time is of the
essence of this Work Order and that OWNER will suffer financial loss if the Work is not
completed within the times specified in paragraph 3 above, plus any extensions thereof
allowed in accordance with Article 12 of the General Conditions. They also recognize the
delays, expenses and difficulties involved in proving in a legal proceeding the actual loss
suffered by OWNER if the Work is not completed on time. Accordingly instead of requiring
any such proof, OWNER and CONTRACTOR agree that as liquidated damages for delay
(but not as penalty) CONTACTOR shall pay OWNER the amounts set forth hereafter.
1) Substantial Completion: Ufive hundred dollarsU ($U500.00U) for each calendar day
or fraction thereof after UNovember 2, 2018U until the work is Substantially
Complete.
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Utilities Work Order – Construction Form Official Purchasing Form
Last updated 10/2017
2) Final Acceptance: After Substantial Completion, Utwo hundred dollarsU
($U200.000U) for each calendar day or fraction thereof after U30 calendar daysU
until the Work is ready for Final Payment and Acceptance.
5. EXECUTION. Work Order Documents must be executed in DocuSign within fifteen (15)
calendar days of the date of this Notice of Award. Contractor shall attach Payment and
Performance Bonds and Certificate of Insurance(COI) to the Work Order Documents in
DocuSign. In addition, one original set of executed Bonds and COI shall be provided to the
Buyer.
Failure to comply with these conditions within the time specified will entitle OWNER to
consider your Work Order Proposal abandoned and to annul this Work Order & Notice of
Award.
UCONTRACTOR’S NOTICE OF AWARD REPRESENTATION & EXECUTIONU:
CONTRACTOR agrees to perform the services identified above, in accordance with the terms
and conditions contained herein, the MASTER AGREEMENT, and the NOTICE OF AWARD
between the parties. In the event of a conflict between or ambiguity in the terms of the MASTER
AGREEMENT or specific Work Orders, the MASTER AGREEMENT shall control.
CONTRACTOR: Granite Inliner
By: Date:
Name: Title:
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Mark Slack District Manager
September 20, 2018
Utilities Work Order – Construction Form Official Purchasing Form
Last updated 10/2017
OWNER’S ACCEPTANCE & EXECUTION:
This Work Order and the attached Documents are hereby accepted and incorporated herein by
this reference.
ACCEPTANCE: Date:
Ray Fisher, Collection Operations Manager
REVIEWED: Date:
Pat Johnson, Senior Buyer
APPROVED AS TO FORM: Date:
Name,City Attorney's Title
(if greater than $1,000,000)
ACCEPTANCE: Date:
Andrew Gingerich, Civil Engineer III
ACCEPTANCE: Date:
Theresa Connor, Utilities Deputy Director
ACCEPTANCE: Date:
Kevin Gertig, Utilities Executive Director
(if greater than $1,000,000)
ACCEPTANCE: Date:
Gerry Paul, Purchasing Director
(if greater than $60,000)
ACCEPTANCE: Date:
Darin Atteberry, City Manager
(if greater than $1,000,000)
ATTEST: Date:
City Clerk
(if greater than $1,000,000)
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September 18, 2018
September 18, 2018
September 20, 2018
September 20, 2018
September 21, 2018
Utilities Work Order – Construction Form Official Purchasing Form
Last updated 10/2017
BID SCHEDULE
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DocuSign Envelope ID: 2A548F07-3BC8-4333-87ED-56922441772E
Granite Inliner
7915 Cherrywood Loop
Kiowa, CO 80117
T 303.646.1200
graniteconstruction.com
August 3rd, 2018
City of Fort Collins
700 Wood Street
Fort Collins, CO 80522
Attention: Mr. Ray Fisher, CWP
Reference: 8123 Cured In Place Pipe
Sanitary Sewer / Storm Water Mains Rehabilitation / Manhole Rehabilitation
Dear Mr. Fisher,
Please review the prices for the upcoming 2018 CIPP and manhole rehabilitation project.
These prices below show the manhole rehabilitation as a schedule A. For manholes that require
more work and materials and are classified as a Manhole B or C there will be an addition charge
per vertical foot. The addition charge per vertical foot to the bottom of the proposed prices.
Item Description Unit Quantity Unit Price Total
1 8 Inch CIPP LF 9845 $ 30.00 $ 295,350.00
2 10 Inch CIPP LF 1931 34.00 65,654.00
3 Service Reinstatement EA 233 20.00 4,660.00
4 Protruding Services EA 20 150.00 3,000.00
5 Manhole Rehabilitation Class A VF 105.2 300.00 31,560.00
Base Total $ 400,224.00
a Manhole Rehabilitation Class B VF 1 $ 50.00 TBD
b Manhole Rehabilitation Class C VF 1 100.00 TBD
Total Grand Total TBD
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Granite Inliner, LLC values the working relationship we enjoy with the City of Fort Collins and
trust we will continue a mutually beneficial agreement. Please call if you have any questions.
Sincerely yours,
GRANITE INLINER, LLC
Reid Sutherland
Project Manager
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2018
CURED IN PLACE PIPE WASTEWATER PROJECTS
QUARTER
SECTION
MANHOLE
NUMBER
PIPE
DIAM STREET / ADDRESS LOCATION
AMT OF
SERVICE
PRO
TAPS
PIPE
LENGTH
COST PER
FOOT TOTAL COSTS
1C 14151-10408 8 2509 N. OVERLAND TRAIL 4 0 300 $29.00 $8,840.00
1C 10408-14150 8 2601 N. OVERLAND TRAIL 4 0 240 $29.00 $7,100.00
6G 20829-18355 8 700 BLOCK CHERRY ST. 7 1 456 $29.00 $13,724.00
6H 15634-13902 8 616 W. OLIVE ST. 3 1 504 $29.00 $14,976.00
6H 13972-11540 8 312 WAYNE ST. 4 2 316 $29.00 $9,814.00
7H 13902-15906 8 518 W. OLIVE ST. 1 1 264 $29.00 $7,946.00
7H 11961-15910 8 518 W. OLIVE ST. 15 4 391 $29.00 $12,884.00
2I 10510-10490 8 732 KIMBALL RD. 6 0 250 $29.00 $7,460.00
2I 10478-10479 8 613 LOUISE LN. 4 0 302 $29.00 $8,898.00
2I 10475-10476 8 505 LOUISE LN. 7 1 210 $29.00 $6,590.00
2I 10472-14308 8 2924 GRENTREE CIR. 6 0 240 $29.00 $7,170.00
2I 10470-14308 8 606 LOCUST GROVE DR. 3 0 292 $29.00 $8,573.00
2I 10471-10470 8 2924 BERKELEY CIR. 6 0 226 $29.00 $6,764.00
2I 10482-14309 8 716 ROCKY RD. 4 1 266 $29.00 $8,109.00
2I 10503-10497 8 828 ROCKY RD. 7 4 367 $29.00 $11,908.00
2I 10507-10503 8 913 ROCKY RD. 8 1 380 $29.00 $11,555.00
3J 10722-10723 8 1204 BRIARWOOD RD. 2 0 199 $29.00 $5,841.00
3J 14669-10703 8 1025 HILLCREST DR. 7 0 400 $29.00 $11,845.00
3J 10690-14660 8 1001 TIMBER LN. 9 0 402 $29.00 $11,973.00
4L 11028-15064 8 2218 WAKEFIELD DR. 8 0 400 $29.00 $11,880.00
4L 15062-15063 8 2206 SCARBOROUGH CT. 8 0 331 $29.00 $9,879.00
4L 11022-15052 8 2324 MANCHESTER CT. 7 0 310 $29.00 $9,235.00
4L 15080-11041 8 2008 YORKTOWN AVE. 3 0 267 $29.00 $7,848.00
8L 14002-12362 10 2516 TULANE DR. 10 0 300 $31.00 $9,650.00
8L 12362-14004 10 421 BAYLOR ST. 8 1 300 $31.00 $9,835.00
8L 14004-14005 10 437 BAYLOR ST. 2 0 142 $31.00 $4,472.00
8L 14008-16361 10 2500 STANFORD RD 9 0 416 $31.00 $13,211.00
8L 16364-16365 10 2112 STOVER ST. 2 0 140 $31.00 $4,410.00
8L 16342-16337 8 124 RUTGERS AVE. 3 0 289 $29.00 $8,486.00
8L 16355-16352 8 2521 TULANE DR. 8 2 422 $29.00 $13,028.00
8L 13401-16353 8 117 PRINCETON RD. 4 0 277 $29.00 $8,173.00
8L 12340-16342 8 300 COLUMBIA RD. 10 1 533 $29.00 $16,062.00
8L 12350-16344 8 304 YALE WAY 9 0 424 $29.00 $12,611.00
8L 16349-12350 8 2404 MATHEWS ST. 2 0 140 $29.00 $4,130.00
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2018
CURED IN PLACE PIPE WASTEWATER PROJECTS
8L 12341-16338 8 304 DARTMOUTH TR. 10 0 447 $29.00 $13,313.00
7-H 15914- 11954 10 100 BLK. SOUTH COLLEGE (WEST ALLEY) 14 0 338 $31.00 $10,968.00
7-H 11954- 13369 10 100 BLK. SOUTH COLLEGE (WEST ALLEY) 1 0 60 $31.00 $1,895.00
7-H 13369 - 13897 10 100 BLK. SOUTH COLLEGE (WEST ALLEY) 7 0 142 $31.00 $4,647.00
7-H 13897 - 11956 10 100 BLK. SOUTH COLLEGE (WEST ALLEY) 1 0 93 $31.00 $2,918.00
TOTALS 233 20 11776 $ 358,621.00
SERVICE TAP REINSTATEMENTS ADD $35 AND INTRUDING TAPS ADD $255 PER SERVICE TO THE TOTAL COST OF EACH LINE SEGEMNT-
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GRANITE INLINER
2018 MANHOLE LINING
(All Manholes 48 Inches Diameter)
1. M12747 4.7’ Depth 1212 Clark Street
2. M12746 7.3’ Depth 1200 Clark Street
3. M12745 9.8’ Depth 1105 Clark Street
4. M12744 8.7’ Depth 1317 Mary Circle
5. M16561 9.3’ Depth Lemay Avenue & Clark Street
6. M14479 11’ Depth Easement S.E. of 2769 MCKEAG Drive
7. M14466 12.2’ Depth Easement S.W. of 2719 MCKEAG Drive
8. M14467 10.2’ Depth Easement S. of 2707 MCKEAG Drive
9. M14509 9.7’ Depth Easement S.E. of 2701 MCKEAG Drive
10. M14468 5.6’ Depth Easement S. of 2625 MCKEAG Drive
11. M14470 7.5’ Depth Easement S.E. of 2625 MCKEAG Drive
12. M14469 9.2’ Depth Easement S.W. of 2521 Tucker Court
TOTAL 105.2 VERTICAL FEET @ $300.00 PER FOOT = $31,560.00
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September 2018
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1
2345678
9101112131415
16 17 18 19 20 21 22
23 24 25 26 27 28 29
30
Pre Video and Clean, 2 wks
Pre Video and Clean, 2 wks
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October 2018
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
123456
7 8 9 10 11 12 13
14 15 16 17 18 19 20
21 22 23 24 25 26 27
28 29 30 31
Pre Video and Clean, 2 wks
Begin CIPP, 4 wks
Begin CIPP, 4 wks
Begin CIPP, 4 wks
Begin CIPP, 4 wks
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November 2018
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
123
45678910
11 12 13 14 15 16 17
18 19 20 21 22 23 24
25 26 27 28 29 30
Begin CIPP, 4 wks
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Utilities Work Order – Construction Form Official Purchasing Form
Last updated 10/2017
SECTION 00530
WORK ORDER NOTICE TO PROCEED
NOTICE TO PROCEED DATE:
WORK ORDER TITLE: 2018 CIPP
WORK ORDER NUMBER: 1-09112018
TO: Granite Inliner
Attn: Reid Sutherland
This notice is to advise you:
That the Work Order and all amendments and supplements to the Work Order Documents
covering the above described Work have been fully executed by the CONTRACTOR and the
OWNER. That the required CONTRACTOR's Performance and Payment Bonds and insurance
have been received by the OWNER. That the OWNER has approved the said Work Order and
Work Order Documents.
Therefore, as the CONTRACTOR for the above described Work, you are hereby authorized and
directed to proceed within ( ) calendar days from receipt of this notice as required
by the Work Order and the AGREEMENT.
The dates for Substantial Completion and Final Acceptance shall be , and ,
respectively.
Dated this _____________ day of ___________, _____.
CITY OF FORT COLLINS (OWNER)
By:
Name, Title
ACKNOWLEDGMENT OF NOTICE
Receipt of the above Work Order Notice to Proceed is hereby acknowledged this Day day of
Month, Year.
(CONTRACTOR)
By: ___________________________________________
Name, Title
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DocuSign Envelope ID: 2A548F07-3BC8-4333-87ED-56922441772E
Utilities Work Order – Construction Form Official Purchasing Form
Last updated 10/2017
SECTION 00600
BONDS AND CERTIFICATES
00610 Performance Bond
00615 Payment Bond
00630 Certificate of Insurance
00635 Certificate of Substantial Completion
00640 Certificate of Final Acceptance
00650 Lien Waiver Release (CONTRACTOR)
00651 Lien Waiver Release (SUBCONTRACTOR)
00660 Consent of Surety
00670 Application for Exemption Certificate
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DocuSign Envelope ID: 2A548F07-3BC8-4333-87ED-56922441772E
Utilities Work Order – Construction Form Official Purchasing Form
Last updated 10/2017
SECTION 00610
PERFORMANCE BOND
Bond No __
KNOW ALL MEN BY THESE PRESENTS: that
Granite Inliner
7815 Cherrywood Loop Kiowa
Kiowa, CO 80117
(an Individual), (a Partnership), (a Corporation), hereinafter referred to as the "Principal" and
(Firm)
(Address)
hereinafter referred to as "the Surety", are held and firmly bound unto City of Fort Collins, 300
LaPorte Ave, Fort Collins, Colorado 80522 a (Municipal Corporation) hereinafter referred to as
the "OWNER", in the penal sum of ($ ) in lawful money of the United States, for the
payment of which sum well and truly to be made, we bind ourselves, successors and assigns,
jointly and severally, firmly by these presents.
THE CONDITIONS OF THIS OBLIGATION are such that whereas the Principal entered into a
certain Master Agreement with the OWNER, dated the Day day of Month, Year, a copy of which
is hereto attached and made a part hereof, for the performance of The City of Fort Collins Work
Order, titled Work Order Project Title, Work Order Number PM's Tracking #, dated Work Order
Date, a copy of which is hereto attached and made a part hereof.
NOW, THEREFORE, if the Principal shall well, truly and faithfully perform its duties, all the
undertakings, covenants, terms, conditions and agreements of said Work Order and Master
Agreement during the original term thereof, and any extensions thereof which may be granted by
the OWNER, with or without Notice to the Surety and during the life of the guaranty period, and if
the Principal shall satisfy all claims and demands incurred under such Work Order and Master
Agreement, and shall fully indemnify and save harmless the OWNER from all cost and damages
which it may suffer by reason of failure to do so, and shall reimburse and repay the OWNER all
outlay and expense which the OWNER may incur in making good any default, then this obligation
shall be void; otherwise to remain in full force and effect.
PROVIDED, FURTHER, that the said Surety, for value received, hereby stipulates and agrees
that no change, extension of time, alteration or addition to the terms of the Work Order and Master
Agreement or to the Work to be performed thereunder or the Specifications accompanying the
same shall in any way affect its obligation on this bond; and it does hereby waive notice of any
such change, extension of time, alteration or addition to the terms of the Work Order and Master
Agreement or to the Work or to the Specifications.
PROVIDED, FURTHER, that no final settlement between the OWNER and the CONTRACTOR
shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied.
PROVIDED, FURTHER, that the Surety Company must be authorized to transact business in the
State of Colorado and be acceptable to the OWNER.
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Utilities Work Order – Construction Form Official Purchasing Form
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IN WITNESS WHEREOF, this instrument is executed in three (3) counterparts, each one of which
shall be deemed an original, this _____ day of ___________, _____.
IN PRESENCE OF: Principal
(Title) (Title)
(Corporate Seal)
(Address)
IN PRESENCE OF: Other Partners
_____________________________ By:
_____________________________ By:
IN PRESENCE OF: Surety
_____________________________ By:
_____________________________
(Address)
(Surety Seal)
NOTE: Date of Bond must not be prior to date of Work Order. If CONTRACTOR is
Partnership, all partners should execute Bond.
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DocuSign Envelope ID: 2A548F07-3BC8-4333-87ED-56922441772E
Utilities Work Order – Construction Form Official Purchasing Form
Last updated 10/2017
SECTION 00615
PAYMENT BOND
Bond No __
KNOW ALL MEN BY THESE PRESENTS: that
Granite Inliner
7815 Cherrywood Loop Kiowa
Kiowa, CO 80117
(an Individual), (a Partnership), (a Corporation), hereinafter referred to as the "Principal" and
(Firm)
(Address)
hereinafter referred to as "the Surety", are held and firmly bound unto City of Fort Collins, 300
LaPorte Ave, Fort Collins, Colorado 80522 a (Municipal Corporation) hereinafter referred to as
the "OWNER", in the penal sum of ($ ) in lawful money of the United States, for the
payment of which sum well and truly to be made, we bind ourselves, successors and assigns,
jointly and severally, firmly by these presents.
THE CONDITIONS OF THIS OBLIGATION are such that whereas the Principal entered into a
certain Master Agreement with the OWNER, dated the Day day of Month, Year, a copy of which
is hereto attached and made a part hereof, for the performance of The City of Fort Collins Work
Order, titled Work Order Project Title, Work Order Number PM's Tracking #, dated Work Order
Date, a copy of which is hereto attached and made a part hereof.
NOW, THEREFORE, if the Principal shall make payment to all persons, firms, subcontractors,
and corporations furnishing materials for or performing labor in the prosecution of the Work
provided for in such Work Order and Master Agreement and any authorized extension or
modification thereof, including all amounts due for materials, lubricants, repairs on machinery,
equipment and tools, consumed, rented or used in connection with the construction of such Work,
and all insurance premiums on said Work, and for all labor, performed in such Work whether by
subcontractor or otherwise, then this obligation shall be void; otherwise to remain in full force and
effect.
PROVIDED, FURTHER, that the said Surety, for value received, hereby stipulates and agrees
that no change, extension of time, alteration or addition to the terms of the Work Order and Master
Agreement or to the Work to be performed thereunder or the Specifications accompanying the
same shall in any way affect its obligation on this bond; and it does hereby waive notice of any
such change, extension of time, alteration or addition to the terms of the Work Order and Master
Agreement or to the Work or to the Specifications.
PROVIDED, FURTHER, that no final settlement between the OWNER and the CONTRACTOR
shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied.
PROVIDED, FURTHER, that the Surety Company must be authorized to transact business in the
State of Colorado and be acceptable to the OWNER.
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Utilities Work Order – Construction Form Official Purchasing Form
Last updated 10/2017
IN WITNESS WHEREOF, this instrument is executed in three (3) counterparts, each one of which
shall be deemed an original, this _____ day of ___________, _____.
IN PRESENCE OF: Principal
(Title) (Title)
(Corporate Seal)
(Address)
IN PRESENCE OF: Other Partners
_____________________________ By:
_____________________________ By:
IN PRESENCE OF: Surety
_____________________________ By:
_____________________________
(Address)
(Surety Seal)
NOTE: Date of Bond must not be prior to date of Work Order. If CONTRACTOR is
Partnership, all partners should execute Bond.
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DocuSign Envelope ID: 2A548F07-3BC8-4333-87ED-56922441772E
Utilities Work Order – Construction Form Official Purchasing Form
Last updated 10/2017
SECTION 00630
CERTIFICATE OF INSURANCE
CONTRACTOR shall submit Certificate of Insurance in compliance with the Work Order
Documents.
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Utilities Work Order – Construction Form Official Purchasing Form
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SECTION 00635
CERTIFICATE OF SUBSTANTIAL COMPLETION
TO: CITY OF FORT COLLINS (OWNER) PROJECT TITLE: 2018 Cured in Place Pipe
DATE OF SUBSTANTIAL COMPLETION: LOCATION: Fort Collins, Colorado
OWNER: City of Fort Collins
PROJECT OR SPECIFIED PART SHALL CONTRACTOR: Granite Inliner
INCLUDE:
WORK ORDER DATE: September 11, 2018
The Work performed under this Work Order, pursuant to the Work Order Documents, has been
inspected by authorized representatives of the OWNER, CONTRACTOR, and the ENGINEER
and the project (or specified part of the project, as indicated above) is hereby declared to be
substantially completed on the above date.
A tentative list of items to be completed or corrected is appended hereto. This list may not be
exhaustive, and the failure to include an item on it does not alter the responsibility of the
CONTRACTOR to complete all the Work in accordance with the Work Order Documents.
_____________________________ By: __________________________ ________
PROJECT MANAGER AUTHORIZED REPRESENTATIVE DATE
The CONTRACTOR accepts the above Certificate of Substantial Completion and agrees to
complete and correct the items on the tentative list within the time indicated.
_____________________________ By: __________________________ ________
CONTRACTOR AUTHORIZED REPRESENTATIVE DATE
The OWNER accepts the project or specified area of the project as substantially complete and
will assume full possession of the project or specified area of the project at 12:01 a.m., on
. The responsibility for heat, utilities, security, and insurance
under the Work Order Documents shall be as set forth under "Remarks" below.
CITY OF FORT COLLINS ________ By: __________________________ ________
OWNER AUTHORIZED REPRESENTATIVE DATE
REMARKS: _________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
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Utilities Work Order – Construction Form Official Purchasing Form
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SECTION 00640
CERTIFICATE OF FINAL ACCEPTANCE
DATE:
TO: Granite Inliner
7815 Cherrywood Loop Kiowa
Kiowa, CO 80117
You are hereby notified that on the Day day of Month, Year, the City of Fort Collins, Colorado,
has accepted the Work completed by Contractor Company Name, for the City of Fort Collins Work
Order, titled Project Title, Work Order Number PM's Tracking #.
Your continuing obligations and guarantees for the Project will be as provided in the Work Order
and Work Order Documents.
Sincerely,
City of Fort Collins
OWNER
By: ___________________________________________
___________________________________________
Name, Title
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Utilities Work Order – Construction Form Official Purchasing Form
Last updated 10/2017
SECTION 00650
LIEN WAIVER RELEASE
(CONTRACTOR)
TO: City of Fort Collins, Colorado (OWNER)
FROM: Granite Inliner
WORK ORDER TITLE: 2018 Cured in Place Pipe
WORK ORDER NUMBER: 1-09112018
1. The CONTRACTOR acknowledges having received payment, except retainage from the
OWNER for all work, labor, skill and material furnished, delivered and performed by the
CONTRACTOR for the OWNER or for anyone in the construction, design, improvement,
alteration, addition or repair of the above described project.
2. In consideration of such payment and other good and valuable consideration, the receipt
and adequacy of which are hereby acknowledged, the CONTRACTOR voluntarily waives
all rights, claims and liens, including but not limited to, mechanic's liens, Miller Act claims
(40 U.S.C.A. 270 a and b), stop notices, equitable liens and labor and material bond rights
which the CONTRACTOR may now or may afterward have, claim or assert for all and any
work, labor, skill or materials furnished, delivered or performed for the construction, design,
improvement, alteration, addition or repair of the above described project, against the
OWNER or its officers, agents, employees or assigns, against any fund of or in the
possession or control of the OWNER, against the project or against all land and the buildings
on and appurtenances to the land improved by the project.
3. The CONTRACTOR affirms that all work, labor and materials, furnished, delivered or
performed to or for the construction, design, improvement, alteration, addition or repair of
the project were furnished, delivered or performed by the CONTRACTOR or its agents,
employees, and servants, or by and through the CONTRACTOR by various Subcontractors
or materialmen or their agents, employees and servants and further affirms the same have
been paid in full and have released in full any and all existing or possible future mechanic's
liens or rights or claims against the project or any funds in the OWNER'S possession or
control concerning the project or against the OWNER or its officers, agents, employees or
assigns arising out of the project.
4. The CONTRACTOR agrees to defend and hold harmless the OWNER, the lender, if any,
and the Surety on the project against and from any claim hereinafter made by the
CONTRACTOR's Subcontractors, materialmen, employees, servants, agents or assigns
against the project or against the OWNER or its officers, employees, agents or assigns
arising out of the project for all loss, damage and costs, including reasonable attorneys fees,
incurred as a result of such claims.
5. The parties acknowledge that the description of the project set forth above constitutes an
adequate description of the property and improvements to which this Lien Waiver Release
pertains. It is further acknowledged that this Lien Waiver Release is for the benefit of and
may be relied upon by the OWNER, the lender, if any, and Surety on any labor and material
bonds for the project.
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Signed this ______ day of __________, ___.
CONTRACTOR: Company Name
By: ___________________________________________
___________________________________________
Name, Title
ATTEST:
_____________________________
Secretary
STATE OF COLORADO )
)ss.
COUNTY OF LARIMER )
Subscribed and sworn to before me this _________ day of __________, _____, by
________________________________________________________________.
Witness my hand and official seal.
My Commission Expires: ___________________________.
_________________________
Notary Public
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SECTION 00650
LIEN WAIVER RELEASE
(SUBCONTRACTOR)
TO: City of Fort Collins, Colorado (OWNER)
FROM: Granite Inliner (CONTRACTOR)
WORK ORDER TITLE: 2018 Cured in Place Pipe
WORK ORDER NUMBER: 1-09112018
1. The Subcontractor acknowledges having received payment from the CONTRACTOR for all
work, labor, skill and material furnished, delivered and performed by the Subcontractor for
the CONTRACTOR or for anyone in the construction, design, improvement, alteration,
addition or repair of the above described project.
2. In consideration of such payment and other good and valuable consideration, the receipt
and adequacy of which are hereby acknowledged, the Subcontractor voluntarily waives all
rights, claims and liens, including but not limited to, mechanic's liens, Miller Act claims (40
U.S.C.A. 270 a and b), stop notices, equitable liens and labor and material bond rights which
the Subcontractor may now or may afterward have, claim or assert for all and any work,
labor, skill or materials furnished, delivered or performed for the construction, design,
improvement, alteration, addition or repair of the above described project, against the
CONTRACTOR or its officers, agents, employees or assigns, against the project or against
all land and the buildings on and appurtenances to the land improved by the project.
3. The Subcontractor affirms that all work, labor and materials, furnished, delivered or
performed to or for the construction, design, improvement, alteration, addition or repair of
the project were furnished, delivered or performed by the Subcontractor or its agents,
employees, and servants, or by and through the Subcontractor by various sub-
subcontractors or materialmen or their agents, employees and servants, and further affirms
the same have been paid in full and have released in full any and all existing or possible
future mechanic's liens or rights or claims against the project or against the CONTRACTOR
or its officers, agents, employees or assigns arising out of the project.
4. The Subcontractor agrees to defend and hold harmless the CONTRACTOR, the lender, if
any, and the Surety on the project against and from any claim hereinafter made by the
Subcontractor's sub-subcontractors, materialmen, employees, servants, agents or assigns
against the project or against the CONTRACTOR or OWNER, lender or Surety or their
officers, employees, agents or assigns arising out of the project for all loss, damage and
costs, including reasonable attorneys fees, incurred as a result of such claims.
5. The parties acknowledge that the description of the project set forth above constitutes an
adequate description of the property and improvements to which this Lien Waiver Release
pertains. It is further acknowledged that this Lien Waiver Release is for the benefit of and
may be relied upon by the CONTRACTOR, OWNER, the lender, if any, and Surety on any
labor and material bonds for the project.
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Signed this ______ day of _________, ___.
SUBCONTRACTOR:
By: ___________________________________________
___________________________________________
Name, Title
ATTEST:
_____________________________
Secretary
STATE OF COLORADO )
)ss.
COUNTY OF LARIMER )
Subscribed and sworn to before me this _________ day of __________, _____, by
__________________________________________________________________.
Witness my hand and official seal.
My Commission Expires: ___________________________.
__________________________________
Notary Public
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SECTION 00660
CONSENT OF SURETY
TO: City of Fort Collins, Colorado (hereinafter referred to as the "OWNER")
CONTRACTOR: Ganite Inliner
TITLE: 2018 Cured In Place Pipe
WORK ORDER NUMBER: 1-09112018
WORK ORDER DATE: September 11, 2018
In accordance with the provisions of the Work Order and Master Agreement between the OWNER
and the CONTRACTOR as indicated above, for the Work Order titled Work Order Project Title on
bond of , (Surety)
_______________________________________ hereby approves of the Final Payment to the
CONTRACTOR, and agrees that Final Payment to the CONTRACTOR shall not relieve the Surety
Company of any of its obligations to the OWNER, as set forth in the said Surety Company's Bond.
IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this _________ day of
_________ _, _____.
____________________________________________
(Surety Company)
By: ________________________________________
(Name) Attorney-in-Fact
ATTACH: Power of Attorney and Certificate of Authority of Attorney(s)-in-Fact.
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SECTION 00800
SUPPLEMENTARY CONDITIONS
These Supplementary Conditions amend or supplement the General Conditions of the
Construction Contract (EJCDC General Conditions 1910-8, 1990 edition, with City of Fort Collins
Modifications, Rev. 9/94) and other provisions of the Work Order Documents as indicated below.
SC-1 DEFINITIONS
SC-1.38. Add the following language to the conclusion of paragraph 1.38 of the General
Conditions:
1.38. Substantial Completion. .... Substantial Completion is further defined as that
degree of completion of the operating facilities or systems of the Project defined in the
Work Order sufficient to provide the OWNER the full time, uninterrupted, continuous,
beneficial operation of the modifications, and all inspections required have been
completed and identified conditions corrected.
SC-1.43.A. Add the following new paragraph immediately after paragraph 1.43 of the General
Conditions:
1.43.A. Work Order--A written document executed by OWNER and
CONTRACTOR that provides for the construction of the Work, or a portion of the Work
pursuant to the Master Agreement and all as required by the Work Order Documents,
and that becomes a Work Order Document when executed.
SC-2 PRELIMINARY MATTERS
SC-2.8. Delete paragraph 2.8 of the General Conditions entirely and replace it with the
following paragraph:
2.8. Preconstruction Conference. Within ten days after the Work Order
Times for a Work Order start to run, but before any Work at the site is started, a
conference attended by CONTRACTOR, ENGINEER and others as appropriate will
be held to establish a working relationship among the parties as to the Work and to
discuss the schedules referred to in paragraph 2.6, procedures for handling Shop
Drawings and other submittals, processing Applications for Payment, and maintaining
required records.
SC-2.10. Add the following new paragraph immediately after paragraph 2.9 of the General
Conditions:
2.10. Work Order Required for All Work. References to the Master Agreement in
this Article 2 and in the General and Supplementary Conditions and Work Order
Documents notwithstanding, no Work shall be initiated or performed until
CONTRACTOR has received a signed and executed Work Order, and the Notice to
Proceed, from OWNER; and no provision of this Article 2 or of the General and
Supplementary Conditions and Work Order Documents shall permit or require any
action of CONTRACTOR in the absence of a signed and executed Work Order. All
provisions of this Article 2 and of the General and Supplementary Conditions and Work
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Order Documents referencing the Master Agreement or other parts of the Work Order
Documents, or permitting or requiring any action of CONTRACTOR, shall be read as
referencing and, as appropriate, requiring a signed and executed Work Order.
SC-4 AVAILABILITY OF LANDS; SUBSURFACE AND PHYSICAL CONDITIONS;
REFERENCE POINTS
SC-4.2.1.2. Add the following new paragraph immediately following paragraph 4.2.1.2 of the
General Conditions:
4.2.1.2.1. No drawing of physical conditions in or relating to existing surface or
subsurface structures (except Underground Facilities referred to in paragraph 4.3)
which are at or contiguous to the site have been utilized by the Engineer in preparation
of the Work Order Documents, except the following:
None
SC-5 BONDS AND INSURANCE
SC-5.4.7. Include the following parties or entities as additional insureds, as provided in
paragraph 5.4.7 of the General Conditions:
5.4.7.1. City of Fort Collins, Colorado, PO Box 580, Fort Collins, CO 80522.
5.4.7.2. NA
SC-5.4.8.1. Add the following new paragraph immediately following paragraph 5.4.8 of the
General Conditions:
5.4.8.1. Limits of Liability. The limits of liability for the insurance required by the
paragraph numbers of the General Conditions listed below are as follows:
For Paragraphs 5.02.A.1 and 5.02.A.2: Coverage A - Statutory Limits; Coverage B -
$100,000 / $100,000 / $500,000.
For Paragraphs 5.02.A.3 and 5.02.A.5: The Commercial General Liability policy will
have limits of $1,000,000 combined single limits (CSL). This policy will include
coverage for Explosion, Collapse, and Underground coverage unless waived by the
Owner.
For Paragraph 5.02.A.6: The Comprehensive Automobile Liability Insurance policy
will have limits of $1,000,000 combined single limits (CSL).
For Paragraph 5.02.B.3: This policy will include completed operations coverage /
product liability coverage with limits of $1,000,000 combined single limits (CSL). This
policy shall also include an Umbrella Excess Liability as follows: General liability and
automobile liability insurance in an amount not less than $1,000,000 per occurrence
in excess of the above stated primary limits.
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SC-6 CONTRACTOR’S RESPONSIBILITIES
SC-6.14.3. Add the following new paragraph immediately after paragraph 6.14.2 of the
General Conditions:
6.14.3. The following Laws or Regulations are included in the Work Order
Documents as mandated by statute or for the convenience of the CONTRACTOR.
Other Laws and Regulations apply which are not included herein, and are within the
CONTRACTOR's duty and responsibility for compliance thereto:
6.14.3.1. Notice to owners of Underground Facilities is required prior to excavations in
the vicinity of such facilities.
6.14.3.2. Unless otherwise decided by reason of the amount of the Work Order Price
involved, or other good reason, before or at the time that the contract is awarded to a
corporation outside the State of Colorado, such corporation must carry out the proper
procedure to become authorized to do business in the State of Colorado, designate a
place of business therein, and appoint an agent for service of process.
Such corporation must furnish the OWNER with a certificate from the Secretary of
State of Colorado has been issued by its office and there shall also be procured from
the Colorado Secretary of State or certified copy of the designated of place of business
and appointment of agent for service of process, or a letter from the Colorado
Secretary of State that such designation of place of business and agent for service of
process have been made.
6.14.3.3. The CONTRACTOR must conform to the rules and regulations of the
Industrial Commission of Colorado. Particular reference is made to rules and
regulations governing excavation Work adopted by the Industrial Commission of
Colorado.
SC-11 CHANGE OF CONTRACT PRICE
SC-11.6.2.7. Add the following new paragraph to paragraph 11.6.2 of the General Conditions:
11.6.2.7. Cost of the Work. Allowances for profit, overhead and mark-up prescribed
by the Master Agreement shall be used in lieu of any CONTRACTOR'S fee, overhead,
profit or mark-up allowances as prescribed in paragraphs 11.6.2.1, 11.6.2.2, and
11.6.2.3.
SC-12 CHANGE OF CONTRACT TIMES
SC-12.3. Add the following language to the end of paragraph 12.3 of the General Conditions:
12.3. .... Lost days due to abnormal weather conditions will be allocated as
required.
SC-14 PAYMENTS TO CONTRACTOR AND COMPLETION
SC-14.1. Add the following language to the end of paragraph 14.1 of the General Conditions:
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14.1. Schedule of Values. .... Progress payments on the fixed fee shall be in
proportion to the cumulative actual Cost of the Work as a percentage of the Allowable
Cost of the Work. An amount not to exceed fifteen (15%) percent of the fixed fee shall
be advanced to the Contractor for mobilization in the first progress payment.
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SECTION 00900
ADDENDA, MODIFICATIONS AND PAYMENT
00950 Change Order
00960 Application for Payment
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SECTION 00950
CHANGE ORDER NO.
PROJECT TITLE: 2018 Cured In Place Pipe
CONTRACTOR: Granite Inliner
WORK ORDER NUMBER: 1-09112018
PO NUMBER:
DESCRIPTION:
1. Reason for Change: Why is the change required?
2. Description of Change: Provide description of the changes to the Work
3. Change in Work Order Price:
4. Change in Work Order Time:
ORIGINAL WORK ORDER PRICE $ .00
TOTAL APPROVED CHANGE ORDER .00
TOTAL PENDING CHANGE ORDER .00
TOTAL THIS CHANGE ORDER .00
TOTAL % OF THIS CHANGE ORDER %
TOTAL C.O.% OF ORIGINAL WORK ORDER %
ADJUSTED WORK ORDER COST $ .00
CONTRACTOR: Company Name
By: Date:
Name: Title:
ACCEPTED: Date:
City PM Name, Title
REVIEWED: Date:
Name, Buyer or Senior Buyer
ACCEPTED: Date:
Name, Title
ACCEPTED: Date:
Gerry Paul, Purchasing Director
(if greater than $60,000)
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SECTION 00960
APPLICATION FOR PAYMENT
PROJECT Page 1 of 1
OWNER:
ENGINEERS:
ADDRESS:
NUMBER DATE AMOUNT
$ -
$ -
$ -
NUMBER DATE AMOUNT FUND OBJECT
Amount Due this Pay Application (before retainage):
$ -
$ -
0.00%
Payment of the above Amount Due This Application has been reviewed by the OWNER'S Project Manager
BY: DATE: DATE:
NAME & TITLE:
BY: DATE:
NAME & TITLE: Official Purchasing Form
Last updated 10/2017
Net Change by Change Order:
Change order %:
Original Contract Amount
Net Change by Change Order
Revised Current Contract Amount
Total Work Completed to Date:
Total Stored to Date:
CHANGE ORDERS PAY APPLICATION
Application is made for Payment as shown below in connection with the Contract.
The present status of the account for this Contract is as follows:
CONTRACTOR:
$ -
$ -
RETAINAGE
$ -NumbersCharge
$ -
$ -
Less Previous Payments:
Total Completed and Stored Materials to Date:
Less Retainage
$ -
$ -
$ -
AMOUNT DUE THIS APPLICATION: $ -
The above Amount Due this Application is requested by the CONTRACTOR's Project Manager.
BY:
PO NUMBER
ADDRESS: ADDRESS:
APPLICATION NUMBER
APPLICATION DATE
PERIOD BEGINNING
PERIOD ENDING
PROJECT NUMBER
Retainage to Date:
NAME & TITLE:
Total (after retainage):
Payment of the above Amount Due This Application is approved by the OWNER.
Utilities Work Order – Construction Form Official Purchasing Form
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Unit Price Total Quanitity Total Quantity Total Quantity Total
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
$ -
$ -
$ -
$ -
$ -
0.00%
$ - $ - $ - $ - $ - 0.00%
Official Purchasing Form
Last Updated 10/2017
Total to Date Less Retention
Change Orders to Date (see attached)
$ -
$ -
CONTRACT SUMMARY
Total Due
Adjusted Contract Amount
$ -
Total Change Order Work to Date (see attached)
Value of Work in Place
Percent Complete Including Stored Materials
Less Retention @ 10% up to 50% complete, 5% beyond 50% of Adjusted Contract
Crosscheck
Total Completed to Date
Total Materials Remaining @ Site
$ -
$ -
$ -
Original Contract Amount
Less Previous Billings $ -
$ -
$ -
$ -
Utilities Work Order – Construction Form Official Purchasing Form
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ATTACHMENT A
DRAWING INDEX
WORK ORDER #1-09112018
WORK ORDER TITLE2018 Cured in Place Pipe
BY: NA
Sheet Title Drawing Revision Date
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$ -
$ -
Combined
Total Completed to Date
Total Contract Amount
Total This Period
Previous Billings
Balance Remaining
Percent Complete
PAY REQUEST
Item # Description Quantity Cost
Remaining
Percent
UOMComplete
Contract Summary This Period Previous Total to Date
Period Ending:
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The undersigned CONTRACTOR certifies that all obligations of CONTRACTOR incurred in connection with the WORK have been satisfied as required in paragraph 14.3 of the General Conditions
of the Contract.
CERTIFICATION
BU
SCOPE OF WORK CHANGE ORDERS
RECONCILIATION CHANGE ORDERS
INVOICE NUMBER
Total Change Order Work to Date:
$ -
$ -
Retainage Previous:
Change in Retainage:
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