HomeMy WebLinkAboutCORRESPONDENCE - BID - 8674 BACKFLOW ASSEMBLY TESTING & REPAIR (3)Work Order Form
Official Purchasing Form
Last updated 10/2017
WORK ORDER FORM
PURSUANT TO A MASTER AGREEMENT BETWEEN
THE CITY OF FORT COLLINS
AND
WORK ORDER NUMBER:
PROJECT TITLE:
ORIGINAL BID/RFP NUMBER & NAME:
MASTER AGREEMENT EFFECTIVE DATE (Contract Signed):
WORK ORDER COMMENCEMENT DATE:
WORK ORDER COMPLETION DATE:
MAXIMUM FEE: (time and reimbursable direct costs):
PROJECT DESCRIPTION/SCOPE OF SERVICES:
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 ( ) page(s) 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: Date:
,
ACCEPTANCE: Date:
, Project Manager
REVIEWED: Date:
, Buyer or Senior Buyer
ACCEPTANCE: Date:
Gerry Paul, Purchasing Director
(if greater than $60,000)
DocuSign Envelope ID: 794ECC1F-A639-450A-A682-4AFCF3F643F5
February 25, 2019
Jill Wuertz
8674 Backflow Assembly Testing and Repair
12/31/2019
2/20/2019
Backflow testing for Parks and Streetscapes
March 1, 2018
2019 Backflow Testing - Parks & Streetscapes
1
$12,671.55
one
March 11, 2019
Scott Campbell Owner
Advanced Backflow LLC
March 11, 2019
Pat Johnson