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PUBLIC WORKS ENGINEERING CONTRACT ROUTING <br /> DATE: 9/27/2004 Contract # 2003.1~8z~-3~ 0~~~~ <br /> AmendmentlAddendum # SIX <br /> Good Job # 4270 <br /> TO: FOR: <br /> ® Project Manager ®Initials ? Signature <br /> ® Division Manager ®Initials ? Signature <br /> ® Public Works Director ? Initials ®Signature <br /> ? City Manager ? Signature <br /> ~ ®PW Admin./Budget(Peggy H mlin) ®Return to: Sarah Maddox X 6034 @ 858 Pearl Street <br /> n(I""?~,~~ (Contract Administrator) <br /> ~0 <br /> Contractor: Pavement Services <br /> Contract Title: Pavement Design -Pool Contract <br /> Manager: Sewazd Meintsma x5364 <br /> Type: ? PS ? AIA ? IGA ? Lease <br /> Begin Date: upon signing Review Date: Term Date: 10/15/04 <br /> Descri tion of contract/a reement: <br /> Add work described in the following attachment: 7112104 Pavement Preservation Program List Desig <br /> Proposal for a not to exceed amount of $64,800.00 <br /> ObsO 5 ©ZC) ~ ~ ~ QC._ <br /> Budget Information: Requisition # Z <br /> Contract Total: $ ~1.~ • ~ P.O. # ~V d~j / ~ ~ ~ t ~Z%x~~. <br /> ~ r <br /> Authorization Name: <br /> Account Code: `~r <br /> Q3Z"~ (Q~~ ~~j~5~ Amount: $64,800.00 <br /> Account Code: Amount: <br /> Account Code: Amount: <br /> Account Code: Amount: <br /> Account Code: Amount: <br /> Total: $64,800.00 <br /> Notes: ~ ~ ~ U ~ C~ ~ Q~_ <br /> Forward To: ? Purchasing ? City Attorney's office City Recorder's office <br /> <br /> Q:~.SUPPORT~PERSERV~forms~Public Works Contract Form090703.doc <br /> <br />