ATTACHMENT E Sample Work Authorization Form.pdf
PDF 1 MB Posted
- Attached to
- FSCP Electrical Services
- Solicitation number
- 147537
- Issued by
- Multnomah County, Oregon
About this file
This document is a Work Authorization Form template used by Portland Public Schools (PPS) in Oregon for contractor work on specific projects, serving as a directive mechanism between the District and electrical or boiler contractors. The form requires contractors to provide all necessary time and materials to complete the detailed Statement of Work in accordance with the contract, PPS Design Guidelines & Standards, and applicable local, state, and federal laws. The work authorization includes designated fields for project identification, performance schedule with start and end dates, deliverables, and contractor information. Contractors must submit monthly invoices with itemized breakdowns of hourly costs and materials supported by receipts, along with Certified Payroll Reports (BOLI form WH-38), and work cannot proceed until the form is signed by both the contractor and the authorized PPS Project Manager.
The form establishes a not-to-exceed pricing structure whereby hourly costs and materials are calculated at rates specified in the applicable Portland Public Schools contract number. Prevailing wage requirements are mandatory on this project in accordance with Oregon's Prevailing Wage Rates for Public Works Contracts, with effective dates to be specified. The document functions as a sample template and explicitly states "THIS IS NOT A DIRECTIVE TO PROCEED WITH THE WORK DESCRIBED HEREIN, UNTIL SIGNED BY APPROVING PARTIES BELOW," requiring formal authorization signatures from both the contractor and PPS Project Manager before work commencement. No set-asides, incumbency information, or specific funding sources are identified in this template form.
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Other files
| File | Type | Posted |
|---|---|---|
| ATTACHMENT B Proposer Certification Form.doc | DOC document | |
| ATTACHMENT D Rate Proposal Form.xlsx | XLSX spreadsheet | |
| ATTACHMENT C Reference Sheet.doc | DOC document | |
| 2026-045 RFP.pdf | ||
| ATTACHMENT A Sample Contract.pdf |
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Text version
Rev 03/2020
WORK AUTHORIZATION – PROJECT NAME
PPS Department Contact____________ eBuilder Project #__________________
PPS Department______________________ Electrical Contractor__________ Work Authorization #__________________ PPS Project Site___________________
STATEMENT OF WORK:
PERFORMANCE SCHEDULE (Project Start/End dates):
DELIVERABLES:
Boiler contractor shall provide all time and materials necessary to perform the Statement of Work detailed above in accordance with the contract and PPS Design Guidelines & Standards (https://www.pps.net/Page/1654). All work shall be conducted in accordance with all local, state and federal laws and the published Portland Public Schools specifications in RFP NUMBER AND TITLE.
Contractor is required to pay Prevailing Wages on this project. (Reference: PREVAILING WAGE RATES FOR PUBLIC WORKS CONTRACTS IN OREGON effective (EFFECTIVE DATES)
THIS IS NOT A DIRECTIVE TO PROCEED WITH THE WORK DESCRIBED HEREIN, UNTIL
SIGNED BY APPROVING PARTIES BELOW.
WORK AUTHORIZATION
In response to the request above, the contractor proposes to perform the scope of work described above for the total time and materials not-to-exceed amount of: $ . Hourly costs and materials shall be calculated at the rates set forth in the Portland Public Schools contract number .
Contractor shall submit to District on a monthly basis, invoices with an itemized breakdown of hourly costs and materials (documented with receipts) and shall include Certified Payroll Reports (BOLI form WH-38).
Signed: Date: _________________________________
Contractor:
AUTHORIZATION TO PROCEED
Signed: __________________________________ Date: __________________________________ Portland Public Schools Project Manager
Project Manager Printed Name __________________________________
SAMPLE
File details come from the government source that posted it. Updated .