HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 9191924Work 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: 0B0B528E-8DD7-4A63-94D9-6634D98FC704
$4,070
Small and Miscellaneous Concrete
Jill Wuertz
3
10/30/2019
ADA Playground Ramp.
See attached quote and scope documents.
October 30, 2019
Westfield ADA ramp
5/1/2020
three
November 7, 2019
November 1, 2019
Elliot Dale
Reed W Nelson Estimator
Fox Construction Systems
November 7, 2019
Fox Construction Systems, LLC
P.O BOX 389
WINDSOR, CO 80550 US
estimating@fcsnoco.com
Estimate
ADDRESS
Jill Wuertz
Westfield Park ADA Ramp
ESTIMATE # DATE EXPIRATION DATE
1028 10/03/2019 10/31/2019
P.O. NUMBER SALES REP
1027 Reed Nelson
DATE ACTIVITY DESCRIPTION QTY RATE AMOUNT
10/03/2019 DEMOLITION Remove & Replace sidewalk adjacent to
corner where ADA ramp is to be installed
24 10.00 240.00
10/03/2019 EXTERIOR
FLATWORK
Excavate, Form & Pour ADA Ramp 100 9.50 950.00
10/03/2019 Structural Fill /
Base Course
Import & Placement of Structural Base
Course
1 400.00 400.00
10/03/2019 Equipment Skid Steer, with breaker attachment 1 980.00 980.00
10/03/2019 CONCRETE
MATERIAL
Concrete Material 5 140.00 700.00
10/03/2019 Concrete
Pumping
Concrete Line Pump 1 800.00 800.00
NOTES:
- Access is very limited, all demo & materials will be hauled in & out by skid
steers
- Concrete price will increase $7/CY as of 11/1/2019 due to winter conditions
- FCS will provide caution tape around the work area, expected duration is one
to two days
- All effort will be made to avoid using the access adjacent to the school, if that
access is required we will have a spotter walk with the equipment to ensure
children and other pedestrians remain clear
EXCLUSIONS:
- Winter Conditions
- Overtime / After Hours Work
- Stamped / Colored Concrete
- Landscaping or any kind
- Traffic / Pedestrian Control beyond what is outlined
TOTAL $4,070.00
Accepted By Accepted Date
DocuSign Envelope ID: 0B0B528E-8DD7-4A63-94D9-6634D98FC704
DocuSign Envelope ID: 0B0B528E-8DD7-4A63-94D9-6634D98FC704
DocuSign Envelope ID: 0B0B528E-8DD7-4A63-94D9-6634D98FC704