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Home My WebLink About2004-063 CONT Chg Order #1 - Acres InternationalCITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541) 488-5300 CITY RECORD Page 1 / 1 03995 I VENDOR: 006911 ACRES INTERNATIONAL 150 NICKETSON STREET SUITE 310 SEATTLE, WA 98020 SHIP TO: Ashland Public Works (541) 488-5587 27-1/2 N MAIN STREET ASHLAND, OR 97520 FOB Point: Terms: Net Req. Del. Date: 01/03/2003 Special Inst: Req. No.: Dept.: PUBLIC WORKS Contact: Paula Brown Confirming? NO THIS IS A REVISED PURCHASE ORDER ~~.._!.DsPecti~n RFP ~~: Jar~uary3,2003 Insurance recluired/On file Chan.qe Order No. 1 as part of existin.q contract SUBTOT~ 69.560.00 mU. TO: Account Payable TAX 0.00 20 EAST MAIN ST FRE~O8'r 0.00, 541-552-2028 TOT~ 69,560.00 ASHLAND, OR 97520 E 670.08.15.00.604130 34,780.00 E 690.11.15.00.604130 34,780.00 A~2XSrize~-d SignAture' VENDOR COPY CITY OF A request for a Purchase Order REQUISTION FORM kSHLAND Date of Request: THIS IS A REQUEST FOR A: [ X ] Change Order (existing PO~ 03995 ) Required Date of Delivery/Service: Vendor Name: ACRES INTERNATIONAL Address: 150 NICKERSON STREET STE 310 City, State, Zip SEATTLE WA 98109 Phone: 2061352-5730 Project Title: HOSLER DAM FERC PART 12 INSPECTION Project Number: 02-28 Services Only [ ] ~BId(coptes m ~) ~ (cop~ ontO) Description HOSLER DAM FERC PART 12 INSPECTION CO 1 Addition of the Failure Modes Analysis as part of ~contract Total Cost Account Number 670.08.15.00.604130 (50%) *Please aa'ach the Otfginal signed contract and Insurance Certes. /~tg~ Account Number 690.11.18.00.604130 (50%) Employee Signature: Supervisor/Dept. Head Signature: /d~~~- ~ NOTE: By s~gning this ~qu~K~ ~certffy th~ above request meets with Cdy of Ashland Soticilfa#on Process requim~nt~n~'can be pmvfded when neuessaty. G:Pul:wwks~Eng~02-28 Acres CO No 1.x15 Updated on: 7115/02 CITY OF ASHLAND DEPARTMENT OF PUBLIC WORKS CONTRACT CHANGE ORDER NO. I (revised) PROJECT: HOSLER DAM FERC PART 12 INSPECTION DATE: AUGUST 21, 2003 LOCATION: HOSLER DAM PROJECT NO.: 02-28 CONTRACTOR: ACRES INTERNATIONAL You are requested to perform the following described work upon receipt of an approved copy of this document or as described by the Engineer: _item No. Description Quantity Unit Price ' Amount CO 1 PFMA Lump sum $13,560.00 $13,560.00 gi tract Amount $56,000.00 Total this Change Order $13,560.00 Previous Change Order Revised Contract Total $69,560.00 The time provided for completion of this contract is increased by no calendar days. This document shall become an amendment to the contract and all provisions of the contract will apply. Recommended By: Approved By: Accepted By: Engi~e~ // C°ntt~"ctor: /Z,~. ~'~'~;.~/~ . Acres International 150 Nickerson Street, Ste 310 Seattle WA 98109 Date Date Date ENOINE~,~G T~: 541-488-5347 ORI$1NAL 20 E. Main Slreet Fax: 541-488-6006 Ashland, Oregon 97520 TrY: 600-735-2900 www. ashland.or.us G;~pul~wrk~e~g~tept-a~min~ENGINEER~PROJECT~2002~02.28 Ch Od 1.doc CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541 ) 488-5300 RECORDER'S COPY Page 1 / 1 (~3995 I VENDOR: 006911 ACRES INTERNATIONAL 150 NICKETSON STREET suITE 310 SEATTLE, WA 98020 SHIP TO: Ashland Public Works (541 ) 488-5587 51 WINBURN WAY ASHLAND, OR 97520 FOB Point: Terms: Net Req. Del. Date: 1/3/2003 Special Inst: Req. No.: Dept.: PUBLIC WORKS Contact: Paula Brown Confirming? No THIS IS A REVISED PURCHASE ORDER ~.~a. fe_~.lnspection , ~ ~ 56,~00.00 RFP ~eginni~g Dat~: ~,~nua~ 3, 2003 ,~**:.***~a**;~** ;~'~'~;:"$~u~ Insurance reguired/On file as pad of existing~co~tra~t Change.Order No. 2 *** This is a change order. *** SU~TOT~ 79,560.00 ~ILL TO: Account Payable ~ 0.00 20 EAST MAIN ST FREI~T 0.00. 541-552-2028 TOT~ 79,560.00 ASHLAND, OR 97520 E 670.08.15.00.604130 39,780.00 E 690.11.15.00.604130 34,780.00 E 690.11.18.00.604130 5,000.00 //JJ VENDOR COPY Authorized Signature A request: for .~ Purch~se Orde,~ REQUISTION FORM THIS IS A REQUEST FOR A: [ X ] Change Order (existing PO# 03995 ) CITY OF ASH LAND Required Date of ehvery/Serv~ce: [~ Vendor Name: Address: City, State, Zip Phone: Project Title: Project Number: ACRES INTERNATIONAL 150 NICKERSON STREET STE 310 SEA/I LE WA 98109 2061352-5730 HOSLER DAM FERC PART 12 INSPECTION 02-28 Services Only Description HOSLER DAM FERC PART 12 INSPECTION CO 1 Addition of the Failure Modes Analysis as part of existing contract ::S°liCitation Process: [ ] ExemPt [ ] ;3 Written QUOtes(copies attached) [:] SOle Source [ ] inVitation:to Bid (copieSon '[ ] Less than $5000 IX ] Request for Proposal (copies on file) CO 2 - Lombardi analysis follow-up Total Cost Account Number 670.08.15.00.604130 (50%) *Please attach the Original signed contract and Insurance Certificates. Account Number 690.11.18.0~ Employee Signature: Supervisor/Dept. Head Signature: NOTE: By signing this requistiion form, I certify tha the above request meets with Cb'y of Ashland Solicitiation Process requfmefCts and can be provided when necessary. G:Pubwrks~Eng\02-28 Acres CO No 2 Updated on: 7/15/02 CITY OF ASHLAND DEPARTMENT OF PUBLIC WORKS CONTRACT CHANGE ORDER NO. 2 PROJECT: HOSLER DAM FERC PART 12 INSPECTION DATE: JUNE 10, 2004 LOCATION: HOSLER DAM PROJECT NO.: 02-28 CONTRACTOR: ACRES INTERNATIONAL You are requested to perform the following described work upon receipt of an approved copy of this document or as described by the Engineer: Item No. Description Quantity Unit Price Amount CO 2 Lombardi Number Analysis Follow-up Lump sum $10,000.00 $10,000.00 Original Contract Amount $56,000.00 Total this Change Order $10,000.00 Previous Change Order $13,560.00 Revised Contract Total $79,560.00 The time provided for completion of this contract is increased by no calendar days. This document shall become an amendment to the contract and all provisions of the contract will apply. Recommended By: Approved By: Accepted By: C o n c~t o r..~'~'~ ~/~~-."~'~~:~,~ Acres International 150 Nickerson Street, Ste 310 Seattle WA 98109 Date Date ENGINEERING Tel: 541-488-5347 20 E. Main Street Fax: 541-488-6006 Ashland, Oregon 97520 TTY: 800-735-2900 www.ashland.or, us G:\pub-wrks\eng\dept-admin\ENGINEER\PROJECT~2002\02.28 Ch Od 2.doc