HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 9200893Work Order Form
Official Purchasing Form
Last updated 10/2017
WORK ORDER FORM
PURSUANT TO A MASTER AGREEMENT BETWEEN
THE CITY OF FORT COLLINS
AND
NORTHERN COLORADO MUD JACKING
WORK ORDER NUMBER: 195734
PROJECT TITLE: Foam Injection
ORIGINAL BID/RFP NUMBER & NAME: 8722
MASTER AGREEMENT EFFECTIVE DATE: 6/15/2018
WORK ORDER COMMENCEMENT DATE: April 1, 2020
WORK ORDER COMPLETION DATE: December 1, 2020
MAXIMUM FEE: (time and reimbursable direct costs): $50,000.00
PROJECT DESCRIPTION/SCOPE OF SERVICES: Sidewalk leveling at various location, as
marked for the SMP rehab projects.
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 One (1) page 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:
Jeremy Bair
ACCEPTANCE: Date:
Angel Ontiveros, Project Manager
REVIEWED: Date:
Elliot Dale, Senior Buyer
ACCEPTANCE: Date:
Gerry Paul, Purchasing Director
(if greater than $60,000)
DocuSign Envelope ID: 3F92E2DB-CED5-4D9A-95A7-E1E9C1BA45B9
5/12/2020
6/1/2020
5/12/2020