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PURCHASE ORDER #20xx-xx 2024-26 Confederated Tribes of Coos, Lower Umpqua and Siuslaw Indians Blanket Purchase Agreement
This Work Order, dated Month, day, year, is between the Confederated Tribes of Coos, Lower Umpqua and Siuslaw Indians (CTCLUSI) and [insert Contractor business name] (Contractor), and references the parties’ 2024-2026 Blanket Purchase Agreement (BPA) to provide [insert one sentence description of work]
Name of Contractor: ___________________________ Company Name: ______________________________ Street Address: _______________________________ City: ________________________ State: __________ Zip Code: _____________
1. Scope of Services Contractor shall perform the services described in Exhibit A (scope of work), attached hereto and incorporated herein.
2. Cost of Services CTCLUSI shall pay Contractor at the target unit prices contained in Exhibit A (scope of work). CTCLUSI’s total payment to Contractor shall not exceed $[insert cost]. If desired, this purchase order (or a copy thereof) may be used by the Contractor as the Contractor's invoice, instead of a separate invoice, provided the following statement, (signed and dated) is on (or attached to) the order: "Payment is requested in the amount of $ [insert cost]. No other invoice will be submitted."
However, if the Contractor wishes to submit an invoice, the following information must be provided: contract number (if any), order number, item number(s), description of supplies or service, sizes, quantities, unit prices, and extended totals.
3. Schedule Contractor shall complete the tasks by the dates set forth in Exhibit A (scope of work). This Purchase Order terminates on Month, Day, Year.
4. Work Area The Work Area will be described to Contractor by CTCLUSI owner Representative in the field. CTCLUSI will provide maps of the project area prior to commencement of work.
5. Effect of Work Order Except as described herein, the Blanket Purchase Agreement shall remain in full force and effect.
Signed by:
CTCLUSI Designee:
Printed Name: ______________________________________ Title: ___________________________________ Signature: _________________________________ Date: __________________________________
Contractor:
Printed Name: ____________________________________ Signature: _________________________________ Business name: __________________________________ Date: _____________________
Exhibit A: Scope of Work
| 2118 |
| 833(1) Culvert Replacement |
| NA |
| LF |
| PER ORDER |
| PER ORDER |
| 2119 |
| 833(2) Culvert Removal |
| 1 |
| EA |
| 2120 |
| 833(3) Water-bar Installation |
| 1 |
| EA |
| 2121 |
| 833(4) Rolling Dip Installation |
| 1 |
| EA |
| 2122 |
| 833(5) Culvert Installation |
| NA |
| LF |
| PER ORDER |
| PER ORDER |
| 2123 |
| 834(1) Clean Ditches |
| 1 |
| MI |
| 2124 |
| 834(2) Clean Ditches & Drainage Structure |
| 1 |
| MI |
| 2125 |
| 834(3) General Road Maintenance |
| 1 |
| LS |
| PER ORDER |
| PER ORDER |
| 2126 |
| 842(1) Cutting Roadway Vegetation |
(10 feet from edge of roadway)
| 2127 |
| 842A(1) Cutting Roadway Vegetation |
(5 feet from edge of roadway)
| 2128 |
| 851(1) Logging Out |
| 1 |
| MI |
(Trees 10" to 24" in diameter)
(Trees > 24" in diameter)
| 2131 |
| 851(4) Hazard or Obstruction Removal |
| 1 |
| EA |
| 2132 |
| 861(1) Maintain Traffic Gate |
| 1 |
| EA |
| 2133 |
| 861(2) Install or Maintain Rock/Earth Barrier |
| 1 |
| EA |
| 2134 |
| 872(1) Install or Replace Single Post and Sign, Govt Furnished |
| 1 |
| EA |
| 2135 |
| 872(2) Install or Replace Double Post and Sign, Govt Furnished |
| 1 |
| EA |
| 2136 |
| 872(3) Install or Replace Sign, |
Govt Furnished
| 2137 |
| 891(1) Water Supply and Watering |
| 1 |
| Mgal |
BPA Call Subtotal:
| 2138 |
| 881(1) Mobilization rate for subtotal amount that is < $10,000 |
| 1 |
| LS |
| 2139 |
| 881(2) Mobilization rate for subtotal amount at > $10,000 to $25,000 |
| 1 |
| LS |
| 2140 |
| 881(3) Mobilization rate for subtotal amount at > $25,000 to $50,000 |
| 1 |
| LS |
| 2141 |
| 881(4) Mobilization rate for subtotal amount that is > $50,000 |
| 1 |
| LS |
BPA Call Subtotal + Applicable Mobilization Rate:
Mgal-1000 gallons, EA-Each, MI-Mile, CY-Cubic Yard, EA-Each, LS-Lump Sum, HR-Hour, LF-Linear Foot