HomeMy WebLinkAbout2003-230 CONT Chg Order #1 - OTAK CITY OF ASHLAND
DEPARTMENT OF PUBLIC WORKS
CONTRACT CHANGE ORDER NO.
PROJECT: WATER STREET BRIDGE REPLACEMENT PROJECT
LOCATION: WATER STREET
CONTRACTOR: OTAK
DATE: OCTOBER 24, 2003
PROJECT NO.: 01-12
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 Additional travel expenses incurred by Time &
contractor Materials NTE $1,000.00 $1,000.00
Original Contract Cost
Total this Change Order
Previous Change Order
Revised Contract Total
$98,263.00
$1,000.00
$o.oo
$99,263.00
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:
E/~gineer ~
Engin~r
OTAK
1 7355 Boones Ferry Road
Lake Oswego OR 97035-521 7
Date/ /
Oat:/~f//'// :5
ENGINEERING Tel: 541488-5347
20 E. Main Street Fax: 541488-6006
Ashland, Oregon 97520 TTY: 800-735-2900
www.ashland.or.us
\\COMPAQl\DATA\GOV~pub-wrks\eng\dept-admin~ENGINEER\PROJECT~2001\01-12 Change Order No 1.doc
CITY OF ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
C!TY RECORDER'S COPY
Page 1 / 1
03225
VENDOR: 005638
OTAK
17355 SW BOONES FERRY ROAD
LAKE OSWEGO, OR 97035-5217
SHIP TO: Ashland Public Works
(541) 488-5587
27-1/2 N MAIN STREET
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date: 04/12/2002
Special Inst:
Req. No.:
Dept.: PUBLIC WORKS
Contact: Paula Brown/Pieter Smeenk
Confirming? No
Quantity Unit::~ · Description Unit Price · Ext. Price
THIS IS A REVISED PURCHASE ORDER
BLANKET PURCHASE ORDER
Engineering Services for the 90,050.06
Water Street Bridge .
Replacement Proiect 01-12
RFP
Date of agreement: April 12, 2002 ' '" ·
Completion date:
Insurance required
Proiect No. 01-12
Revised purchase order 08/01/2003
Deducted June 03 payments
Payment #13 $7289.98, less retainage
/?,?, $729 00
Pavment//14 $1025.51, less retainage
~ ~ $102.55
Revised purchase order 12/19/2003 1,000.00
Increased contract amount to $98,263.00
('Per requisition/Change order #1)
·. Change Order #1 - Additional travel ·
expenses incurred bv contractor
SUBTOTAL 91,050.06
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2028 TOTAL 91,050.06
ASHLAND, OR 97520
E 260.08.12.00.704200 91,050.06
VENDOR COPY
A request for a Purchase Order
REQUISTION FORM
CITY OF
kSHLAND
THIS IS A REQUEST FOR A:
[ X ] Change Order (existing PO# 3225
Required Date of Delivery/Service: IASAP :..'1
Vendor Name:
Address:
City, State, Zip
Phone:
Project Title:
Project Number:
OTAK
17355 SW BOONES FERRY ROAD
LAKE OSWEGO OR 97035-5217
WATER STREET BRIDGE REPLACEMENT PROJECT
01-12
Solicitation Process:
] Exempt [ ] 3 Written Quotes (copies
attached)
[ ] Sole Source [ X ] Invitation to Bid (copies on
file)
[ ] Less than $5000 [ ] Request for Proposal (copies
on file)
Services Only
Description Total Cost
Water Street Bridge Replacement Engineering Services $ 98,263.00 Original Contract Cost
Not To Exceed cost for time and materials for additional travel expenses
$ 1,000.00 CO#1
Prior Change Orders
$ 99,263.00 REVISED CONTRACT
Employee Signature:
NOTE: By signing this
Account Number 260.08.12.00.704200
*Please attach the Odginal signed contract and Insurance Certificates.
~0.4 '~i~,~~ Supervisor/Dept. Head Signature:
r~quistiio~ ~ ~eftify tha the above request meets with Ctiy of Ashland Solicitiation Process requirerr~nts,~nd tan be provided when necessary.
/
G: Pubwrks\Eng\01-12 CO I Requisition 10 03.xls Updated on: 7/15~02