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HomeMy WebLinkAbout06225"AS AMENDED" ORDINANCE NO. 6225 AN ORDINANCE APPROVING A CONTRACT, PROJECT NO. MP R- 200 -018 (10629) BETWEEN PUEBLO, A MUNICIPAL CORPORATION, AND THE COLORADO DEPARTMENT OF TRANSPORTATION, AND AUTHORIZING THE PRESIDENT OF CITY COUNCIL TO EXECUTE THE SAME BE IT ORDAINED BY THE CITY COUNCIL OF PUEBLO, COLORADO, THAT SECTION 1. The Contract between the City of Pueblo, a Municipal Corporation, and the Colorado Transportation Department concerning the construction of an upgraded traffic signal at the intersection of Pueblo Blvd. and Surfwood Lane (Project MP R- 200 -018 (10629). SECTION 2. The President of the City Council is hereby authorized to execute this Contract for and on behalf of the City and the City Clerk is authorized and directed to attest same and affix the Seal of the City thereto. SECTION 3. This ordinance shall become effective immediately upon passage and approval. Introduced July 14, 1997 By Al Gurgle Councilperson APPROVED: President of 19e Cit Council ATTEST: City Cler Traffic Signal/Pueblo MP R- 200 -018 (10629) RWB CONTRACT Routing No. 97 HA2 O / 0 -� y THIS CONTRACT, made this day of 19 1 , by and between the STATE OF COLORADO, for the use and benefit of the DEPARTMENT OF TRANSPORTATION, hereinafter referred to as "CDOT," and the CITY OF PUEBLO, COLORADO, 350 South Elizabeth, PO Box 1427, Pueblo, Colorado 81002, hereinafter referred to as "City ", WHEREAS, authority exists in the law and funds have been budgeted, appropriated, and otherwise made available for payment in Fund No. 400, Orgn. 9991, Appropriation Code 010, Program No. 3000, Function 2300, Object 3127 T(I), Reporting Category 2400, Project No. 10629 [00] B, (CONTRACT ENCUMBRANCE AMOUNT SIXTY FIVE THOUSAND DOLLARS EXACTLY, ($65,000.00); and WHEREAS, required approval, clearance and coordination has been accomplished from and with appropriate agencies; and WHEREAS, CDOT desires to upgrade the traffic signal at Pueblo Boulevard and Surfwood (S.H. 45 M.P. 2.7 - a State highway) in Pueblo, hereinafter referred to as "the work "; and WHEREAS, the City and the State desire to enter into this Intergovernmental Agreement to provide for State funding for the work; and WHEREAS, the City has estimated the total cost of the Work and is prepared to accept responsibility for the performance of the work; and WHEREAS, this contract is executed by the City under the authority granted by a resolution, attached hereto as Exhibit B, which authorizes a specific individual to execute this contract and to bind City to its terms; and WHEREAS, this contract is executed by the State under authority of §24 -16 -101 et seq., 24- 92 -101 et seq., 29 -1 -203, 43 -1 -110, 43 -1 -116, 43- 2- 101(4)(c) and 43 -2 -144, C.R.S., as amended; and WHEREAS, the parties agree upon the division of responsibilites with regard to this project; .1J 1 WHEREAS, the Local Agency is adequately staffed and suitably equipped to undertake and satisfactorily complete the work; and WHEREAS, the State certifies that such work can be more advantageously performed by the Local Agency. NOW THEREFORE, it is hereby agreed: I PROJECT DESCRIPTION "The Project or "The work" for which this contract is written is Project No. MP R200 -017 10629 which consists of replacement of the traffic signal at Pueblo Boulevard and Surfwood as more specifically described in Exhibit A (Scope of Work) attached hereto and incorporated herein by this reference. The Work shall be performed by the City under the supervision of CDOT's Project Manager. H. PROJECT FUNDING PROVISIONS A. The State and the City have estimated the cost of Work to be SIXTY FIVE THOUSAND DOLLARS EXACTLY ($65,000.00). B. The maximum amount payable to the Local Agency under this shall be $65,000.00 unless increased by a written supplemental agreement. M. STATE COMMITTMENTS A. The State will provide liaison with the City and supervision of the Work through the State's Project Manager, Terry Shippy, (719) 546 -5734, Maintenance Division - Pueblo, 905 Erie Ave., Pueblo, CO 81002. The Project Manager will also be responsible for coordinating the State's activities under this contract. B. Pending approval of the costs by the State's Project Manager, the State shall pay to the City an amount not to exceed SIXTY FIVE THOUSAND DOLLARS EXACTLY ($65,000.00) covering all costs of the work. Such approval shall not be unreasonably be withheld. C. Upon completion, the State shall review the project to ensure that the Work has been performed in accordance with applicable State Specifications and Standards. 2 IV. LOCAL AGENCY COMMITMENTS A. Upon completion of the Work and acceptance by the State the City shall prepare and submit to the State an invoice for all costs incurred relative to the project. entry onto land, temporary construction easements, easements for construction use of detours, and all other rights in real property required for the work. B. City will comply with the applicable provisions of the State's approved Action Plan, including all federal directives contained therein by reference. Copies of the applicable provisions may be requested for the Office of Environmental Services, Colorado Department of Transportation, 4201 E. Arkansas Ave., Room 284, Denver, CO 80222. C. City shall obtain all necessary permits, variances, clearances, rights of way, and be responsible for coordinating with all agencies, including utilities. D. The City shall maintain all books, documents, papers, accounting records and other evidence pertaining to costs incurred and to make such materials available for inspection at all reasonable times during the contract period and for 3 years from the date of final payment to the Local Agency. Copies of such records shall be furnished by the City if requested. V. GNERAL PROVISIONS A THE VENDOR SHALL PERFORM ITS DUTIES HEREUNDER AS AN INDEPENDENT CONTRACTOR AND NOT AS AN EMPLOYEE. NEITHER THE VENDOR NOR ANY AGENT OR EMPLOYEE OF THE VENDOR SHALL BE, OR SHALL BE DEEMED TO BE, AN AGENT OR EMPLOYEE OF THE STATE, AND THEY SHALL HAVE NO AUTHORIZATION, EXPRESS OR IMPLIED, TO BIND THE STATE TO ANY AGREEMENTS, SETTLEMENTS, LIABILITY, OR UNDERSTANDING EXCEPT AS EXPRESSLY SET FORTH HEREIN. THE VENDOR SHALL BE RESPONSIBLE TO THE STATE FOR THE ULTIMATE RESULTS OF PERFORMANCE REQUIRED HEREUNDER, BUT SHALL NOT BE SUBJECT TO THE DIRECTION AND CONTROL OF THE STATE AS TO THE MEANS AND METHODS OF ACCOMPLISHING THE 3 RESULTS. THE SPECIFICATIONS IN THIS CONTRACT OF PARTICULAR PERFORMANCE STANDARDS THAT THE STATE DEEMS ESSENTIAL TO PROPER PERFORMANCE AND CONTRACT VALUE SHALL IN NO EVENT BE DEEMED TO ALTER THIS RELATIONSHIP. THE VENDOR SHALL PAY WHEN DUE ALL REQUIRED EMPLOYMENT TAXES AND INCOME TAX WITHHOLDING, INCLUDING ALL FEDERAL AND STATE INCOME TAX ON ANY MONEYS PAID PURSUANT TO THIS CONTRACT. THE VENDOR SHALL PROVIDE AND KEEP IN FORCE LIABILITY INSURANCE (AND SHOW PROOF OF SUCH INSURANCE) IN THE AMOUNTS REQUIRED BY LAW, AND SHALL BE SOLELY RESPONSIBLE FOR THE ACTS OF THE VENDOR. THE VENDOR ACKNOWLEDGES THAT THE VENDOR AND ITS EMPLOYEES ARE NOT ENTITLED TO THE BENEFITS OF WORKER'S COMPENSATION INSURANCE OR UNEMPLOYMENT INSURANCE UNLESS THE VENDOR OR A THIRD PARTY PROVIDES SUCH COVERAGE AND THAT THE STATE DOES NOT PAY FOR OR OTHERWISE PROVIDE SUCH COVERAGE. B. The vendor and the State shall be cognizant of all Federal and State laws and local ordinances and regulations which in any manner affect those engaged or employed in the performance of the work or which in any way affect the conduct of the performance of the work, and of all such orders and decrees of bodies or tribunals having any jurisdiction or authority over the same, and shall at all times observe and comply with all such existing laws, ordinances, regulations and decrees. The vendor shall protect and indemnify the State against any claim or liability arising solely from or based solely on the violations of any such law, ordinance, regulation, order or decree, whether by itself, its subcontractors, agents or employees. C. (1) All estimates, reports, data and miscellaneous items purported to contribute to the completeness of the project shall be delivered to and become the property of the State. Basic notes, charts, computations, and other data 51 prepared hereunder shall be made available to the State, upon request, and become the property of the State. All data received hereunder shall be made a part of the State's permanent records and files and preserved therein. (2) The vendor shall maintain a complete file of all records, communications, and other written materials which pertain to the performance and costs of the services, and shall maintain such records for a period of three years after the date of termination of this contract, or for such further period as may be necessary to resolve any matters which may be pending. (3) The vendor shall permit the State to audit and/or inspect its records pertaining to the services authorized by this contract during the term of this contract and for a period of three years following the termination of the contract, to assure compliance with the terms hereof, or to evaluate the vendor's performance hereunder. (4) All medical and psychological data on individual persons shall remain in the possession of the vendor. If it becomes necessary for the State auditor to review such data in order to conduct an audit as provided for in paragraph (3) above, the State agrees to keep the information reviewed confidential D. This Contract may be terminated as follows: (1) Termination for Cause If, through any cause, the Vendor fails to fulfill in a timely and proper manner all obligations under this contract, or if the Vendor violates any of the covenants, agreements, or stipulations of this contract, the State shall thereupon have the right to terminate this contract for cause by giving written notice to the Vendor of such termination and specifying the effective date thereof, at least five days before the effective date of such termination. In that event, all finished or unfinished documents, data, studies, surveys, drawings, maps, models, photographs, and reports or other material prepared by the Vendor under this contract shall, at the option of the State, become the property of the State, and the Vendor shall be entitled to receive just and equitable compensation for any satisfactory services completed on such documents and other materials. Notwithstanding the above, the Vendor shall not be relieved of liability to the State for any damages sustained by the State by virtue 5 of any breach of the contract by the Vendor, and the State may withhold any payments to the Vendor for the purpose of setoff until such time as the exact amount of damages due the State from the Vendor is determined. (2) Termination for Convenience The State may cancel upon 60 -day written notice to the other party. The State shall effect such termination by giving written notice of termination to the Vendor and specifying the effective date thereof, at least 60 days before the effective date of such termination. In that event, all finished or unfinished documents and other materials as described in the preceding Paragraph shall, at the option of the State, become the property of the State. If the contract is terminated by the State as provided herein, the Vendor will be paid an amount which bears the same ratio to the total compensation as the services actually performed bear to the total services of the Vendor covered by this contract, less payments of compensation previously made; provided, however, that if less than sixty percent (60 %) of the services covered by this contract have been performed upon the effective date of such termination, the Vendor shall be reimbursed (in addition to the above payment) for that portion of the actual out -of- pocket expenses (not otherwise reimbursed under this contract) incurred by the Vendor during the contract period which are directly attributable to the uncompleted portion of the services covered by this contract. If this contract is terminated due to the fault of the Vendor, the preceding Paragraph hereof relative to termination shall apply. (3) Termination Due to Loss of Funding The parties hereto expressly recognize that the Vendor is to be paid, reimbursed, or otherwise compensated with State funds for the purpose of contracting for the services provided for herein, and therefore, the Vendor expressly understands and agrees that all its rights, demands and claims to compensation arising under this contract are contingent upon availability of such State funds. In the event that such funds or any part thereof are not available to the State, the State may immediately terminate or amend this contract. (4) Erroneous Termination for Default. If, after notice of termination of the Vendor's right to proceed under the provisions of this section, it is determined for any reason C*1 that the Vendor was not in default under the provisions of this section, or that the delay was excusable, the rights and obligations of the parties shall be the same as if the notice of termination had been issued pursuant to the termination for convenience clause. E. (1) The vendor shall not engage the services of any person or persons then in the employ of the State for services covered by the terms of this contract without the written consent of the State. (2) It is the intent hereunder to secure the personal services of the vendor, in manner aforesaid, and this contract shall not be assigned, sublet or transferred without the consent, in writing, of the State. F. The term of this contract shall begin on the date first written above and shall extend through completion of the and acceptance by the State of the work, unless earlier terminated as provided herein. Financial obligations of the State of Colorado payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted, and otherwise made available. G. To the extent that this contract may be executed and performance of the obligations of the parties may be accomplished within the intent of the contract, the terms of this contract are severable, and should any term or provision hereof be declared invalid or become inoperative for any reason, such invalidity or failure shall not affect the validity of any other term or provision hereof. The waiver of any breach of a term hereof shall not be construed as a waiver of any other term, or the same term upon subsequent breach. H. This contract is intended as the complete integration of all understandings between the parties. No prior or contemporaneous addition, deletion, or other amendment hereto shall have any force or effect whatsoever, unless embodied herein by writing. No subsequent novation, renewal, addition, deletion, or other amendment hereto shall have any force or effect unless embodied in a written contract executed and approved pursuant to the State Fiscal Rules. I. Except as herein otherwise provided, this contract shall inure to the benefit of and be 7 s binding upon the parties hereto and their respective successors and assigns. J. The vendor represents and warrants that it currently has no interest, and shall not acquire any interest, direct or indirect, that would conflict in any manner or degree with the performance of the vendor's services under this contract. The vendor further covenants that, in the performance of this contract, it will not employ any person or firm having any such known interests. K. The vendor represents and warrants that it has taken all actions that are necessary or that are required by its procedures, bylaws, or applicable law, to legally authorize the undersigned signatory to execute this contract on behalf of the vendor and to bind the vendor to its terms. L. The local agency assures and guarantees that it possesses the legal authority to enter into this contract. The local agency warrants that it has taken all actions required by its procedures, by -laws, and/or applicable law to exercise that authority, and to lawfully authorize its undersigned signatory to execute this contract and to bind the local agency to its terms IN WITNESS WHEREOF, the parties hereto have executed this contract on the day and year first above written. STATE OF COLORADO ROY ROMER, GOVERNOR ATTEST: ATTEST: By Title City Clerk DEPARTMENT OF TRANSPORTATION By r ig/ E cutive Director CITY OF PUEBLO By Signature aro Titl President of City Council FEIN No. 840368819 APPROVED: CLIFFORD W. HALL State Controller By GALE A. NORTON Attorney Gen By !/ Barry B. Ryan Assistant Attorney General Civil Litigation 07 DOH FORM NO. 15 COLORADO DEPARTMENT OF HIGHWAYS REV. APRIL, 1983 PURCHASE REQUISITION THIS FORM FOR INTERNAL USE ONLY. D INDICA SHIP TO: COLORADO DEPT. OF HIGHWAYS BILL TO: COLORADO DEPT. OF HIGHWAYS STREET PUEBLO BLVD. & SURFWOOD STREET (P.O. BOX) P .O. BOX 536 CITY Pueblo ZIP 81002 CITY Pnehln ZIP 81002 ATTN: TERRY SHIPPY ATTN: GERALD WATSON OH MU QUANTITY UNIT COMPLETE DESCRIPTION OF ITEM OR SERVICE UNIT COST AMOUNT S $ SERVICE CONTRACT $ Contract between the COLORADO DEPT. OF TRANSPORATATION and the CITY OF PUEBLO, 350 S. Elizabeth Street, Pueblo, CO. 81003 The City of Pueblo anticipates a base project for the installation of a traffic signal at the intersection of Pueblo Blvd. & Surfwo d (S.H. 45 M.P. 2.7) This is a intersection upgrade with four mast arm signal poles, a two -phase 170 E controller with video detect'on and associated equipment will be installed. The City of Pueblo will be responsible for the materials and some minor sub - contractor work. TOTAL 65,000 OOH INVENTORY NO's. FOR CAPITAL EQUIPMENT: IMPORTANT ODNTA T PERSM: T0W SHIPPY CDO►P 546 -5734 PRICING INFORMATION MUST ^ a DIM CERM CITY OF PUEBLO 545 -5840 BE FILLED IN. PRICING DETERMINED BY ❑ LOW BID 10 CONTRACT ❑ PRICE AGREEMENT ❑ EMERGENCY ❑ ONLY AVAILABLE SOURCE IN AREA ❑ SOLE SOURCE ❑ OTHER (PLEASE EXPLAIN) JUSTIFICATION FOR THIS REQUEST: upgrading traffic signal at the intersection of Pueblo B lvd. & Surfwood, in Pueblo. FOR (INDICATE NAME AND NUMBERS ON EQUPIMENT UNITS) MP 8200 -018 10629 COST CENTER AND /OR PROJECT NO. IF GOODS HAVE BEEN RECEIVED, ATTACH VOUCHER REQUEST AND INVOICE REQUISITION. Send To: Highway Procurement Office REQUES (Via Dept. 4201 East Arkansas Ave., WA Mail) Denver, Colorado 80222 APPROVED FOR COMMODITY VENDOR AND ADDRESS: CIT O PUEBLO 350 S. Eli zabeth St. Pueblo, OD. 81003 ATTN: DAN CIINTA, TRAFFIC ENGINEER DELIVERY: F.O.B. OBJECT I FUNCTION TERMS: QUOTE SOLE SOURCE BID o.n . �NO. 136322 DATE 5/12/ FIRM ION INVOICE REC'D." ON THE Mtc. Supt.: _ R.T.D. cz:s � TnFn 9 B ORIGINAL- WHITE (PROCUREMENT BRANCH) DUPLICATE - BLUE (DISTRICT OR DIVISION) TRIPLICATE - PINK (ORIGINATING OFFICE) VENDORS SOLICITED RESPONSE tllDOL S AWARDED MBE WBE TOTAL NO PW S $ $ ORIGINAL- WHITE (PROCUREMENT BRANCH) DUPLICATE - BLUE (DISTRICT OR DIVISION) TRIPLICATE - PINK (ORIGINATING OFFICE) TRAFFIC SIGNAL/PUEBLO Routing No. DAJ CONTRACT AMENDMENT #1 THIS AMENDMENT, is made this day of ' 19____ by and between the State of Colorado for the use and benefit of the Department of Transportation hereinafter referred to as "the State" or "CDOT" and the CITY OF PUEBLO, COLORADO, 350 South Elizabeth, P.O. Box 1427, Pueblo, Colorado 81002 (FEIN 840368819), hereinafter referred to as the "City"or "Local Agency". FACTUAL RECITALS Authority exists in the law and funds have been budgeted, appropriated and otherwise made available and a sufficient unencumbered balance thereof remains available for payment in Fund 400, Org. No. 9991, Appropriation Code 010, Program 3000, Function 2300, Object 3127 T (N), Reporting Category 2400, Project No. 10629 [00] B. Total Encumbrance Amount this Amendment: EIGHT HUNDRED SIXTY TWO DOLLARS AND TWO CENTS ($862.02); Required approval, clearance, and coordination has been accomplished from and with appropriate agencies; and The parties have heretofore entered into a contract dated October 24, 1997, hereinafter referred to as the `Basic Contract" which provided for upgrade of the traffic signal at Pueblo Boulevard and Surfwood (S.H. 45 M.P. 2.7 - a state highway) in Pueblo, which is still in effect as of the date of this first Contract Amendment; and The Basic Contract provides for an increase in the maximum amount payable by written supplemental agreement; and The parties now desire to amend the Basic Contract to increase the maximum amount payable to under the contract to $65,862.02, as specifically described in Exhibit A attached hereto and incorporated herein by this reference. NOW THEREFORE, it is hereby agreed that 1. Consideration for this Amendment to the Basic Contract consists of the payments which shall be made pursuant to this Amendment and the promises and agreements herein set forth. 2. This Amendment, inclusive of Exhibit A attached hereto, is supplemental to the Basic Contract, which is, by this reference, incorporated, and made a part hereof, and all terms, conditions, and provisions thereof, unless specifically modified herein, are to apply to this Amendment as though they were expressly rewritten, incorporated, and included herein. 3. The Basic Contract is and shall be modified, altered, and changed in the following respects only: A. Exhibit A of the Basic Contract shall be amended by the incorporation of Exhibit A of this Contract Amendment . B. Paragraph II A of the Basic Contract is deleted and amended to read "The state and the city have estimated the cost of the work to be SIXTY FIVE THOUSAND EIGHT HUNDRED SIXTY TWO DOLLARS AND TWO CENTS EXACTLY ($65,862.02) ". C. Paragraph H B of the Basic Contract is deleted and amended to read "The maximum amount payable to the Local Agency under this Contract shall be $65,862.02 ", unless increased by a written supplemental agreement ". D. In paragraph III B, the reference to " SIXTY FIVE THOUSAND DOLLARS EXACTLY ($65,000.00) ", is deleted and amended to read "SIXTY FIVE THOUSAND EIGHT HUNDRED SIXTY TWO DOLLARS AND TWO CENTS EXACTLY ($65,862.02) ". 4. Except for the "Special Provisions," in the event of any conflict, inconsistency, variance, or contradiction between the provisions of this Amendment or any of its attachments or exhibits, and any of the provisions of the Basic Contract, this Amendment shall in all respects supersede, govern and control. The "Special Provisions" shall always be controlling over other provisions in the contractor amendments. The factual representations in the Special Provisions concerning the absence of bribery or corrupt influences and personal interest of State employees are presently reaffirmed. FINANCIAL OBLIGATIONS OF THE STATE PAYABLE AFTER THE CURRENT FISCAL YEAR ARE CONTINGENT UPON FUNDS FOR THAT PURPOSE BEING APPROPRIATED, BUDGETED, AND OTHERWISE MADE AVAILABLE. 6. THIS AMENDMENT SHALL NOT BE DEEMED VALID UNTIL IT SHALL HAVE BEEN APPROVED BY THE CONTROLLER OF THE STATE OF COLORADO OR SUCH ASSISTANT AS HE MAY DESIGNATE. 2 IN WITNESS WHEREOF, the parties hereto have executed this Amendment on the day first above written. STATE OF COLORADO ROY ROMER, GOVERNOR as ATTEST: By Chief Cle C Y OF P BLO By Title �fpcf�. col' T4srs �arrh FEIN 840368819 ATTORNEY GENERAL GALE A. NORTON By BARRY B. RYAN Assistant Attorney General Civil Litigation Section Executive Director, Department of Transportation ATTEST By Title APPROVALS STATE CONTROLLER CLIFFORD W. HALL By GEORGE McCULLAR CDOT Controller 3 DOH FORM NO. 1s _ COLORADO DEPARTMENT OF HIGHWAYS ' _ REV. APRIL, 1.,:183 PURCHASE REQUISITION EXHIBIT THIS FORM FOR INTERNAL USE ONLY. NO. 136330 DATE 4/6/98 SHIPTO: COLORADO DEPT. OF HIGHWAYS BILLTO: COLORADO DEP OF HIGHWAYS STREET Pueblo Blvd. & Surfwood STREET (P.O. BOX) P.O. BOX 536 CITY Pueblo Z i p 81002 CITY Pueblo ZIP 81002 ATTN: TERRY SHIPPY ATTN: GERALD WATSON OH MU QUANTITY UNIT COMPLETE DESCRIPTION OF ITEM OR SERVICE UNIT COST AMOUNT COST CENTER AND /OR PROJECT NO. WBE TOTAL NO B'I SUPPLEMENT TO SERVICE CONTRACT 97 HA201029 5 ............. Contract between the COLO. DEPT. OF TRANSPORTATION and the CITY OF PUEBLO 350 S. Elizabeth St. Pueblo, CO. 81003 Additional funds are needed to complete the installation of a traffic signal at the intersection of Pueblo Blvd. & Surfwood. 1 ea Auxilary Control Cabinet . TOTAL 862.02 CANnCr PERSON: TERRY SNIPPY (719) 546 -5734 DAN CENTA, City of Pueblo (719) 545 -5840 DOH INVENTORY NO's. FOR CAPITAL EQUIPMENT: IMPORTANT PRICING INFORMATION MUST BE FILLED IN. PRICING DETERMINED BY ❑ LOW BID X) CONTRACT ❑ PRICE AGREEMENT ❑ EMERGENCY ❑ ONLY AVAILABLE SOURCE IN AREA ❑ SOLE SOURCE ❑ OTHER (PLEASE EXPLAIN) JUSTIFICATION FOR THIS REQUEST: Traffic signal upgrade at the intersection of Pueblo Blvd_ and Surfwood in Pueblo. FOR (INDICATE NAME AND NUMBERS ON EQUPIMENT UNITS) MP R200 -018 ( 10629) OBJECT FUNCTION N/P -TN 1 2300 COST CENTER AND /OR PROJECT NO. IF GOODS HAVE BEEN RECEIVED, ATTACH VOUCHER REQUEST AND INVOI A INDICATE .' O FIRMA ION INVOICE HEU UN I Ht REQUISITION. Send To: Highway Procurement Office REQU T tC.t. 11 (Via Dept. 4201 East Arkansas Ave., WA Mail) Denver, Colorado 80222 APPROVED R.T.D. FOR PURCHASING USE ONLY COMMODITY QUOTE VENDOR AND ADDRESS: P.A. SOLE SOURCE BID n n BID oin r TI _ JFl J DATE ATTN DELIVERY: F.O.B TERMS: ORIGINAL- WHITE (PROCUREMENT BRANCH) DUPLICATE - BLUE (DISTRICT OR DIVISION) TRIPLICATE - PINK (ORIGINATING OFFICE) VENDORS SOLICITED RESPONSE DOLLARS AWARDED MBE $ WBE TOTAL NO B'I $ 5 ............. ORIGINAL- WHITE (PROCUREMENT BRANCH) DUPLICATE - BLUE (DISTRICT OR DIVISION) TRIPLICATE - PINK (ORIGINATING OFFICE)