1530* Killebrew, Inc PO 33114 & WO RFQ 11/12-024 i sm
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PURCHASING DEPARTMENT
Wednesday, November 14, 2012
T RANSMITTAL MEMORANDUM
TO: City Clerk
RE Killebrew Inc., PO 33114 and Work Order RFQ 11/12 -02
The item(s) noted below is /are attached and forwarded to your office for the following action(s):
❑ Development Order
❑ Final Plat (original mylars)
❑ Letter of Credit
❑ Maintenance Bond
❑ Ordinance
❑ Performance Bond
❑ Resolution
El
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Mayor's signature
r ng in p V
ity Manager
Payment Bond
City Manager Signature
City Clerk Attest /Signature
Once completed, please:
® Return originals to Purchasing
❑ Return copies
Special Instructions:
Safe keeping
Marisol Ordonez
From
�r r�
Date
TADept_ forms \City Clerk Transmittal Memo - 2009.doc
DATE: 10/26/12
PURCHASING OFFICE: 407.688.5030
ACCOUNTS PAYABLE: 407.688.5020
FACSIMILE: 407.688.5021
VENDOR NO.: 11849
TO:
KILLEBREW, INC
PO BOX 6258
LAKELAND, FL
PURCHASE ORDER
CITY OF SANFORD
P.O. BOX 1788
(300 NORTH PARK AVENUE)
SANFORD, FLORIDA 32772
FLORIDA TAX EXEMPT NO.: 858012621681C -8
PO NUMBER 033114
SUBMIT INVOICES TO: ACCOUNTS PAYABLE
FINANCE DEPT.
P.O. BOX 1788
SANFORD, FL 32772
SHIP TO:
CITY OF SANFORD }�
300 N. PARK AVENUE ✓
33807 -6258 SANFORD, FL 32771
DELIVER BY
TERMS
F.O.B. DESTINATION
BID OR QUOTATION NO.
REQUISITION NO.
UNLESS OTHERWISE INDICATED
09/30/13
NET /30
63482
ACCOUNT NO.: 452-4530-536.63-03 PROJECT NO.: DW 110 3
NO DEVIATION FROM THIS PURCHASE ORDER WILL BE ALLOWED UNLESS AUTHORIZED BY THE PURCHASING MANAGER - CITY OF SANFORD
ITEM NO.
DESCRIPTION
QUANTITY
UNIT OF
ISSUE
UNIT COST
EXTENDED COST
1
WATER QUALITY IMPROVEMENT (CIP)
365248.52
NA
1.00
365248.52
AREA 11 GRANDVIEW
UPGRADING OF EXISTING WATER SYSTEM
SUB
TOTAL
365248.52
TOT
L
365248.52
APPROVED BY: Al APPROVED BY:
% PURCHASING AGENT ! #A NAG
ALL PACKAGES AND INVOICES ASSOCIATED WITH THIS P.O. MUST BEAR THIS PURCHASE ORDER NUMBER. THE VENDOR IS RESPONSIBLE TO CAREFULLY
READ AND COMPLY WITH ALL OF THE STANDARD TERMS AND CONDITIONS PROVIDED ON THE REVERSE SIDE OF THIS PURCHASE ORDER
AND AT HTTP : //WWW DEPARTMENTS /PURCHASE/TERMS.HTML
COPIES TO: VENDOR ORIGINATING DEPARTMENT PURCHASING
EXHIBIT A
WORK ORDER FORM
Act# 452 - 4530 - 536 -63 -00 Work Order Number 1
CITY OF SANFORD FLORIDA
Master Agreement/Contract Number:
Dated: 09/13/2012
Contract/Project Title City of Sanford Water Quality Improvement Project
Solicitation No: RFQ 11/12 -02
ISanford Project No. DW1103
Purchase Order No.
Consultant/Contractor: Killebrew, Inc
Consultant/Contractor's Business Address, Phone Number, Fax Number and E -mail Address
10614 E US Highway 92, Tampa FL 33610 -5972 Ph:813- 968 -7277 Fax: 813 - 443 -0530
ATTACHMENTS TO THIS WORK ORDER
METHOD OF COMPENSATION
X
DRAWINGS /PLANS /SPECIFICATIONS
IFIXED FEE BASIS
X
SCOPE OF SERVICES
TIME BASIS -NOT TO EXCEED AMOUNT
SPECIAL CONDITIONS
TIME BASIS - LIMITATION OF FUNDS
PRICING IINFORMATION
X
UNIT PRICE BASIS -NOT TO EXCEED AMOUNT
WO TERMS AND CONDITIONS
TIME FOR COMPLETION: 150 Days Days of the effective date to this Work Order
Effective date- this Work Order: Date of Execution by City
Time for completion: The services to be provided by the Consultant/Contractor shall commence upon execution
of this Work Order by the parties and shall be completed within the time frame indicated above. Failure to meet
the stated completion requirement may be grounds for termination for default.
Work Order Amount: Dollars Expressed in Numbers: $ 365,248.52
Dollar Amount Written Out: Three hundred and sixty-five thousand two hundred forty-eight 52/100
In Witness Whereof, the parties hereto have made and executed this Work Order on the respective dates under each
signature: The City as delegated through its City Commission taking action on the 13 day of August 13, 2012 and the
Consultant/Contractor by and through its duly authorized corporate officer having the full and complete authority to
execute same.
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ATTEST: EXECUTION:
Signature, Corporate Officer Signature, Corporate President
f L /7��Z
Corporate Officer Printed Name, Title and Date Corporate President, Printed Narlie a Dat
CITY OF SANFORD
Signature, Purchasing nager
F. Willi4n Smith
Purchasing ManAger, Printed Name and Date
r
Signature, ity Cler Mayor
Jul //- j >-1 Triplett - p�
City Clerk, PnTfted Naine and Date Mayor, Printed Name and Date
/-/I
Revised: 1 -6 -2011