HomeMy WebLinkAboutCORRESPONDENCE - BID - 8165 MULBERRY BRIDGE AT NEW MERCER DITCH BRIDGE REPLACEMENT (2)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
SERVICE PROVIDER'S NAME
WORK ORDER NUMBER:
PROJECT TITLE: PIP top off for NACC
ORIGINAL BID/RFP NUMBER & NAME: 8164 Playground Surfacing Construction
Services
MASTER AGREEMENT EFFECTIVE DATE: 9/4/2015
WORK ORDER COMMENCEMENT DATE: 12/15/2017
WORK ORDER COMPLETION DATE: 6/1/2018
MAXIMUM FEE: (time and reimbursable direct costs): $14817.40
PROJECT DESCRIPTION/SCOPE OF SERVICES: Install a ½” cap of poured-in-place rubber
over entire surface of Northside Park playground
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 (1) 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:
Name, Title
ACCEPTANCE: Lea Ann Haisch Date: 12/13/2017
Name, Project Manager
REVIEWED: Date:
Name, Buyer or Senior Buyer
ACCEPTANCE: Date:
Gerry Paul, Purchasing Director
(if greater than $60,000)
DocuSign Envelope ID: D0271AD2-55EB-4D2E-871E-E662B2C61DA2
12/13/2017
12/14/2017