2467 RFQ 20/21-23 CCNA -Task Authorization0 SACITNY OF /F)
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FINANCE DEPARTMENT
Thursday, March 02, 2023
PURCHASING DEPARTMENT
'°T'RANSMI'TTAL MEMORANDUM
To: City Clerk/Mayor
RE: Task Authorization Form RFQ 20/21-23 CCNA
The item(s) noted below is/are attached and forwarded to your office for the following action(s):
❑
Development Order
❑
Mayor's signature
❑
Final Plat (original mylars)
❑
Recording
❑
Letter of Credit
❑
Rendering
❑
Maintenance Bond
Safe keeping (Vault)
❑
Ordinance
❑
Deputy City Manager
❑
Performance Bond
❑
Payment Bond
❑
Resolution
❑
City Manager Signature
❑
❑
City Clerk Attest/Signature
❑
City Attorney/Signature
Once completed, please:
❑ Return originals to Purchasing- Department
❑ Return copies
❑
Special I tructions:
From
TADept_forms\City Clerk Transmittal Memo - 2009.doc
312-123
Date
RSP 10, IN
FINANCE DEPARTMENT
TASK AUTHORIZATION FORM ISSUED BY CITY OF SANFORD
Task Authorization -N - 0 -.-,: --- I_
Project Title: Heritage Park
Contractor/Consultant/Vendor: Professional Services Inc.,
Agreement Date and Solicitation Number: September 27, 2021 RFQ 20/21-23 CCNA
This Task Authorization implements the above -referenced Agreement and assigns work
to be performed under the Agreement. The terms, conditions and provisions of the
Agreement apply to and govern all work under this Task Authorization Form. The
Contractor shall not under any circumstances attach to any document, which proposes
in conjunction with this Task Assignment or otherwise propose any term, condition or
provision relating to the work. A Contractor/Consultant/vendor so doing will be in breach
of the Agreement and will be engaging in conduct, which the City will deem to be as
unethical.
Execution of this Task Authorization by the City shall serve as authorization for the
Contractor/Consultant/Vendor to provide the above project, professional services as set
out herein and further delineated in the specifications, conditions and requirements
stated in the following listed documents, which are attached hereto and made a part
hereof.
ATTACHMENTS (Check all that apply):
Drawings/Plans/Specification
Detailed Services and Task for project or Study
Special Conditions
Schedule of Subcontractor Participation (approved by the City).
Other please specify
Time for completion: The work authorization by this Task Authorization shall be
commenced upon receipt of apurchase order by the Contractor/Consultant/Vendor and
shall be completed with ) calendar days from date of the purchase order
issued by the City to the Contractor/Consultant/Vendor. Each enumerated task shall be
completed in accordance with the contract time schedule set forth below.
RFQ 20/21-23 CCNA City of Sanford
Task Authorization Form 00860-1
TASK AUTHORIZATION(EXAMPLE —INSERT SPECIFIC TASKS)
Description ofWork: Peer Review ofthe following documents.
1.Preliminary Geotechnka|Exploration, prepared byUniversal Engineering Sciences, dated 8/IS/I6
ZDesign Geotechnical Report, prepared byUniversal Engineering Sciences (U[S),dated August 31,ZO22
3. Concept Plans, prepared by RI Heisenbottle Architects, P.A., dated March 13, 2020.
4. Survey Plan, prepared by CPH, Inc.
S.Rendered Site Plan
Contract Price: $4,821.00 PER PSI PROPOSAL O757-3837G8DATED 9/27/22
Contract Time: 30 days
Description of Work:
Contract Price:
Contract Time:
Description of Work:
RF[J2O/21'23CCNACity ofSanford
Contract Price:
Contract Time:
RFQ 20/21-23 CCNA City of Sanford
Task Authorization Form 00860-3
FINANCE DEPARTMENT
W, X-11 1114 1, 1
Description of Work:
Contract Price:
Contract Time:
TASK 5
Description of Work:
Contract Price:
Contract Time:
Total Contract Time: 30 days
Total Contract Price- $4,R21,00
TASK AUTHORIZATION SUMMARY
No. Description Contract Price Contract Time
1 Geotechnical Peer Review $4,821.00 30
2
3
14 1
5 1
TOTAL $4,821.00 30 Days
RFQ 20/21-23 CCNA City of Sanford
Task Authorization Form 00860-4
'% �f�• CITY OF
.5A1�F0�
FINANCE DEPARTMENT
APPROVAL OF TASK AUTHORIZATION AND ACKNOWLEDGMENTS
IN WITNESS WHEREOF, the City and following named
Contractor/Consultant/Vendor have executed this instrument for the purpose herein
expressed.
ATTEST.
Traci Houchin, MMC, FCR `=.1'`
City Clerk �• F
Approved as to form and
legal sufficiency.
Print Name
Title:
RFQ 20/21-23 CCNA City of Sanford
Task Authorization Form 00860-5
CITY OF SANFORD
By:
Craig Radzak
Assistant City Maage
Date: V
(Professional Services, Inc)
Print Name
Title: FL, 66oTECW"KA(-
Dated: 11 �2 3