HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 9185401Utilities Work Order Form
Official Purchasing Form
Last updated 10/2017
WORK ORDER
PURSUANT TO A MASTER AGREEMENT BETWEEN
THE CITY OF FORT COLLINS
AND
ELITE INDUSTRIES
WORK ORDER NUMBER: 2216984-1
PROJECT TITLE: WR&B Rock and Retaining Walls
ORIGINAL BID/RFP NUMBER & NAME: 8197 Small Landscape & Irrigation On-call
MASTER AGREEMENT EFFECTIVE DATE: March 1, 2016
ARCHITECT/ENGINEER: N/A
OWNER’S REPRESENTATIVE: Nick Smiley
WORK ORDER COMMENCEMENT DATE: 9/25/2018
WORK ORDER COMPLETION DATE: 5/30/2019
MAXIMUM FEE: (time and reimbursable direct costs): $7800.00
PROJECT DESCRIPTION/SCOPE OF SERVICES: Repairs on Mulberry retaining walls, Install
rock in 3 beds at Drake
Service Provider agrees to perform the services identified above and on the attached forms in
accordance with the terms and conditions contained herein and in the Master Agreement between
the parties. In the event of a conflict between or ambiguity in the terms of the Master Agreement
and this Work Order (including the attached forms) the Master Agreement shall control.
The attached forms consisting of Estimate 263 (1) pages are hereby accepted and incorporated
herein, by this reference, and Notice to Proceed is hereby given after all parties have signed this
document.
SERVICE PROVIDER: Elite Industries
By: Date:
Name: Title:
DocuSign Envelope ID: FC06EFF7-DF71-478A-ACFD-A921A15DA75B
Jenna Bensko Office Manager
10/11/2018
Utilities Work Order Form
Official Purchasing Form
Last updated 10/2017
OWNER’S ACCEPTANCE & EXECUTION:
This Work Order and the attached Contract Documents are hereby accepted and incorporated
herein by this reference.
ACCEPTANCE: Date:
Nick Smiley, Project Manager
REVIEWED: Date:
Elliot Dale, Buyer or Senior Buyer
DocuSign Envelope ID: FC06EFF7-DF71-478A-ACFD-A921A15DA75B
10/11/2018
10/15/2018
Estimate
Date
8/28/2018
Estimate #
263
Name / Address
City of Fort Collins - Nick
3036 Environmrntal Drive
Fort Collins, CO 80525
PO BOX 1883
FORT COLLINS, CO 80522
Project
Thank you for your business!
Phone # 970.224.3900 E-mail Brad@EliteIndustriesInc.com
Total
Description Qty Rate Total
Fort Collins Mulberry Water Treatment
Repair Timber Retaining Wall (Middle)
Repair 20 sections of timber wall 1 1,600.00 1,600.00
Repair Timber Retaining Wall (North)
Repair 10 sections of timber wall 1 1,200.00 1,200.00
B. Install 3/4" Rainbow Rock in 3 rock beds - 1,306 sq. ft. 1 5,000.00 5,000.00
$7,800.00
DocuSign Envelope ID: FC06EFF7-DF71-478A-ACFD-A921A15DA75B
Certificate Of Completion
Envelope Id: FC06EFF7DF71478AACFDA921A15DA75B Status: Completed
Subject: Please DocuSign: WOEliteFall2018.docx, Elite Added work 8_2018.pdf
Source Envelope:
Document Pages: 3 Signatures: 3 Envelope Originator:
Certificate Pages: 5 Initials: 0 Nick Smiley
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
215 N Mason Street
Fort Collins , CO 80522
nsmiley@fcgov.com
IP Address: 198.59.47.100
Record Tracking
Status: Original
10/9/2018 7:22:51 AM
Holder: Nick Smiley
nsmiley@fcgov.com
Location: DocuSign
Signer Events Signature Timestamp
Jenna Bensko
Jenna@eliteindustriesinc.com
Office Manager
Elite Industries Inc
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 24.9.58.144
Sent: 10/9/2018 7:28:29 AM
Viewed: 10/11/2018 9:37:41 AM
Signed: 10/11/2018 9:41:13 AM
Electronic Record and Signature Disclosure:
Accepted: 10/11/2018 9:37:41 AM
ID: e60d03fb-22ff-46ed-a660-ecc98025de80
Nick Smiley
nsmiley@fcgov.com
City of Fort Collins – Water Resources & Treatment
Operations
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 198.59.47.100
Sent: 10/11/2018 9:41:14 AM
Viewed: 10/11/2018 9:57:50 AM
Signed: 10/11/2018 9:57:58 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Elliot Dale
edale@fcgov.com
Buyer
City of Fort Collins
Security Level: Email, Account Authentication
(None)
Signature Adoption: Uploaded Signature Image
Using IP Address: 198.59.47.100
Sent: 10/11/2018 9:57:59 AM
Viewed: 10/15/2018 8:28:52 AM
Signed: 10/15/2018 8:29:12 AM
Electronic Record and Signature Disclosure:
Accepted: 10/30/2017 1:20:56 PM
Carbon Copy Events Status Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 10/11/2018 9:57:59 AM
Certified Delivered Security Checked 10/15/2018 8:28:53 AM
Signing Complete Security Checked 10/15/2018 8:29:12 AM
Completed Security Checked 10/15/2018 8:29:12 AM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
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Electronic Record and Signature Disclosure created on: 3/24/2016 2:25:27 PM
Parties agreed to: Jenna Bensko, Elliot Dale
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ID: 161512c6-157b-462e-bc6a-dd2b9ac6c724
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