ADDENDUM TO AGREEMENT FOR CONSTRUCTION OF MARSHALL STREET & EAST APCF CHLORINE GAS AND SULFUR DIOXIDE GAS CONVERSION PROJECT - 07-0021-UT
ADDENDUM TO AGREEMENT FOR CONSTRUCTION OF
MARSHALL STREET & EAST APCF CHLORINE GAS AND SULFUR DIOXIDE
GAS CONVERSION PROJECT
CITY OF CLEARWATER CONTRACT No. 07-0021-UT
In reference to contract #07-0021-UT dated January 8, 2010 between City of Clearwater, the Owner, and TLC
Diversified, Inc, the Contractor, it is further AGREED as follows:
1. The Owner has reserved the right to purchase certain portions of the material for the Project directly in order
to save applicable sales tax in compliance with Florida Law since owner is exempt from the payment of sales tax.
2. The attachments lettered "A", "B", and "C", attached hereto (as amended by notations thereon) and
incorporated herein shall be executed by the Contractor and applicable Sub-contractors and the terms thereof shall
govern the purchase of materials for the Project as determined by the Owner.
3. The contract price shall be reduced by the cost of the materials purchased by owner plus the normally
applicable sales tax as bid by the Contractor even if the cost is in excess of the cost for the materials as bid by the
Contractor. However, for purposes of calculating engineering fees, contractor fees, architects fees, and any other
amounts that are based on the contract amount, the original contract amount shall be used.
4. The Contractor reserves the right to authorize payments for invoiced materials, prior to Owner's
authorization process, as outlined in Attachment "D".
5. The Contractor will assist Owner in owner's direct purchase of materials for the project. However, owner
acknowledges that Contractor's Sub-contractors nonetheless each reserves the right to purchase project materials
directly, without Owner's prior approval and consequent power to eliminate reimbursement of sales tax.
This addendum, upon its execution by both parties, is made an integral part of the aforementioned agreement.
CITY OF CLEARWATER:
Date: 4 1'
William B. Horne II
City Manager/Owner
ATTEST:
C hia E. Goudeau
Ci lerk
(C it s Corporate Seal)
AS TO
Leslie K. Doug
Assistant City
?I
CONTRACTOR:
D 3j?n 1r??
Contractor
ATTACHMENT "A"
FROM CITY OF CLEARWATER (OWNER)
TO. TLC DIVERSIFIED INC. (CONTRACTOR)
OWNER-FURNISHED MATERIALS
PROJECT: MARSHALL STREET & EAST C CHLORINE GAS A SULFUR DIOXI E A
CONVERSION PROJECT (07-0027-UT)
1. The Contract Price includes Florida sales and other applicable taxes for material, supplies, and equipment
which will be a part of the Contractor's Work. The owner, being exempt from sales tax, reserves the right to make
direct purchases of various construction materials included in the Contractor's contract. Owner-purchasing of
construction material, if selected, will be administered on a deductive Change Order basis. Additionally, Purchase
Orders will include Owner's Certificate of Exemption number.
2. The Contractor shall provide the Owner a list of all intended suppliers, vendors, and material for
consideration as Owner-Furnished Materials. The Contractor shall submit price quotes from the vendors, as well as a
description of the materials to be supplied, estimated quantities, and prices.
3. The Contractor shall be fully responsible for all matters relating to the receipt of materials furnished by the
Owner in accordance with these Special Provisions including, but not limited to, verifying correct quantities, verifying
documents of orders in a timely manner, coordinating purchases, providing and obtaining all warranties and
guarantees required by the Contract Documents, inspection and acceptance of the goods at the time of delivery due to
the negligence of the Contractor. However, the owner assumes the risk of damage or loss during the time that
the building materials are physically stored at the job site prior to their installation or incorporation into the
project. The Contractor shall coordinate delivery schedules, sequence of delivery, loading orientation, and other
arrangements normally required by the Contractor for the particular material furnished. The Contractor shall provide all
services required for the unloading and handling of materials. The Contractor agrees to indemnify and hold harmless
the Owner from any and all claims of whatever nature resulting from non-payment of goods to suppliers arising from
the action of the Contractor.
4. As Owner-Furnished Materials are delivered to the job site, the Contractor shall visually inspect all
shipments from the suppliers, and approve the vendor's invoice for material delivered. The Contractor shall assure that
each delivery of Owner-Furnished Materials is accompanied by documentation adequate to identify the Purchase
Order against which the purchase is made. This documentation may consist of a delivery ticket and an invoice from the
supplier conforming to the Purchase Order together with such additional information as the Owner may require. The
Contractor will then forward the invoice to the Owner for payment, pursuant to Attachment A of this Contract.
5. The Contractor shall insure that Owner-Furnished Materials conform to the Specifications and determine
prior to acceptance of goods at time of delivery if such materials are patently defective, and whether such materials are
identical to the materials ordered and match the description on the bill of lading. If the Contractor discovers defective or
non-conformities in Owner-Furnished Materials upon such visual inspection, the Contractor shall not utilize such
nonconforming or defective materials in the Contractor's Work and instead shall properly notify the Owner of the
defective or nonconforming condition so that repair or replacement of those materials can occur without undue delay or
interruption to the Project. If the Contractor fails to perform such inspection and otherwise incorporates into the
Contractor's Work such defective or nonconforming Owner-Furnished Materials, the condition of which it either knew
or should have known by performance of an inspection, Contractor shall be responsible for all damages to the Owner,
resulting from Contractor's incorporation of such materials into the Project, including liquidating or delay damages.
6. The Contractor shall maintain records of all Owner-Furnished Materials it incorporates into Contractor's
Work from the stock of Owner-Furnished Materials in its possession. The Contractor shall account monthly to the
Owner for any Owner-Furnished Materials delivered into the Contractor's possession, indicating portions of all such
materials which have been incorporated in the Contractor's Work.
7. The Contractor shall be responsible for obtaining and managing all warranties and guarantees for all
materials and products as required by the Contract Documents. All repair, maintenance, or damage-repair calls shall
be forwarded to the Contractor for resolution with the appropriate supplier, vendor, or subcontractor.
8. Notwithstanding the transfer of Owner-Furnished Materials by the Owner to the Contractor's possession, the
Owner shall retain legal and equitable title to any and all Owner-Furnished Materials.
9. The Owner shall indemnify and hold Contractor harmless from any sales tax (and interest and penalties
incurred in connection therewith) in the event there is a final determination that sales made by Owner, which Owner
treats as being exempt from sales tax, are subject to sales tax. "Final determination" shall mean an assessment by the
Department of Revenue that is no longer subject to protest, or a determination of a court having jurisdiction over such
matters that is final and not subject to appeal. Contractor agrees to promptly notify owner of any audit, assessment,
proposed assessment or notice of deficiency issued with regard to the Project and relating to Owner-Furnished
Materials.
10. As invoices are received, Contractor shall be required to review invoices submitted by all suppliers of
Owner-Furnished Materials delivered to the Project during that delivery for use by the Contractor and either concur or
object to the Owner's issuance of payment to the suppliers, based upon Contractor's records of materials delivered to
the site and any defects in such materials.
11. In order to arrange for the prompt payment to the supplier, the Contractor shall provide to the Owner a
listing indicating the acceptance of the goods or materials within thirty (30) days of receipt of said goods or materials.
The list shall include a copy of all applicable Purchase Orders which will include owner's Certificate of Exemption
number, invoices, delivery tickets, written acceptance of the delivered item, and such other documentation as may be
reasonably required by the Owner, The check will be released, delivered and remitted directly to the supplier. The
Contractor agrees to assist the Owner to immediately obtain partial or final release or waivers as appropriate. At the
end of the Project, Contractor will be provided with a deductive Change Order for the cost incurred by the Owner to
provide all Owner-Furnished Materials. Salvage materials shall be stored or removed from the site by the Contractor at
the Owner's direction, or may be turned over to the Contractor for salvage or disposal at the Contractor's option.
12. The Contractor shall be entitled to the benefits of any discounts attributable to the early payment of vendor
invoices for materials furnished by the Owner pursuant to the Specifications.
13. The Contract between Contractor and Owner is hereby amended to clarify that Owner-Furnished Material
shall be included in the Cost of the Work for the purpose of determining the Contract Sum due Contractor.
ATTACHMENT "B"
FROM TLC Diversified Inc. (CONTRACTOR)
TO Blue Planet Environmental Systems. Inc. C/O Heyward Florida Inc. (SUBCONTRACTOR)
OWNER-FURNISHED MATERIALS
PROJECT: MARSHALL STREET & EAST APCF CHLORINE AS AND SULFUR DIOXIDE GAS
CONVERSION PROJECT (07-0021-UT)
1. The Contract Price includes Florida sales and other applicable taxes for material, supplies, and equipment
which will be a part of the Subcontractor's Work. The Owner, being exempt from sales tax, reserves the right to make
direct purchases of various construction materials included in the Subcontractor's contract. Owner-Purchasing of
construction material, if selected, will be administered on a deductive Change Order basis. Additionally, Purchase
Orders will include owner's Certification of Exemption number.
2. The Subcontractor shall provide the owner a list of all intended suppliers, vendors, and material for
consideration as Owner-Furnished Materials. The Subcontractor shall submit price quotes from the vendors, as well as
a description of the materials to be supplied, estimated quantities, and prices.
3. The Subcontractor shall be fully responsible for all matters relating to the receipt of materials furnished by
the Owner in accordance with these Special Provisions including, but not limited to, verifying correct quantities,
verifying documents of orders in a timely manner, coordinating purchases, providing and obtaining all warranties and
guarantees required by the Contract Documents, inspection and acceptance of the goods at the time of delivery due to
the negligence of the Subcontractor. However, the Owner assumes the risk of damage or loss during the time
that the building materials are physically stored at the job site prior to their installation or incorporation into
the project. The Subcontractor shall coordinate delivery schedules, sequence of delivery, loading orientation, and
other arrangements normally required by the Subcontractor for the particular material furnished. The Subcontractor
shall provide all services required for the unloading and handling of materials. The Subcontractor agrees to indemnify
and hold harmless the Owner from any and all claims of whatever nature resulting from non-payment of goods to
suppliers arising from the action of the Subcontractor.
a. As Owner-Furnished Materials are delivered to the job site, the Subcontractor shall visually inspect all
shipments from the suppliers, and approve the vendor's invoice for material delivered. The Subcontractor shall assure
that each delivery of Owner-Furnished Materials is accompanied by documentation adequate to identify the Purchase
Order against which the purchase is made. This documentation may consist of a delivery ticket and an invoice from the
supplier conforming to the Purchase Order together with such additional information as the Owner may require. The
Subcontractor will then forward the invoice to the Owner for payment, pursuant to Attachment "A" of this Contract.
5. The Subcontractor shall insure that Owner-Furnished Materials conform to the Specifications and determine
prior to incorporation into the Subcontractor's Work if such materials are patently defective, and whether such
materials are identical to the materials ordered and match the description on the bill of lading. If the Subcontractor
discovers defective or non-conformities in Owner-Furnished Materials upon such visual inspection, the Subcontractor
shall not utilize such nonconforming or defective materials in the Subcontractor's Work and instead shall properly notify
the Owner of the defective or nonconforming condition so that repair or replacement of those materials can occur
without undue delay or interruption to the Project. If the Contractor fails to perform such inspection and otherwise
incorporates into the Subcontractor's Work such defective or nonconforming Owner-Furnished Materials, the condition
of which it either knew or should have known by performance of an inspection, Subcontractor shall be responsible for
all damages to the owner, resulting from Subcontractor's incorporation of such materials into the Project, including
liquidating or delay damages.
6. The Subcontractor shall maintain records of all owner-Furnished Materials it incorporates into
Subcontractor's Work from the stock of Owner-furnished Materials in its possession. The Subcontractor shall account
monthly to the Owner for any owner-Furnished Materials delivered into the Subcontractor's possession, indicating
portions of all such materials which have been incorporated in the Subcontractor's Work.
7. The Subcontractor shall be responsible for obtaining and managing all warranties and guarantees for all
materials and products as required by the Contract Documents. All repair, maintenance, or damage-repair calls shall
be forwarded to the Subcontractor for resolution with the appropriate supplier, vendor, or sub-subcontractor.
8. Notwithstanding the transfer of Owner-Furnished Materials by the Owner to the Subcontractor's possession,
the Owner shall retain legal and equitable title to any and all Owner-Furnished Materials.
9. The Owner shall indemnify and hold Subcontractor harmless from any sales tax (and interest and penalties
incurred in connection therewith) in the event there is a final determination that sales made by Owner, which Owner
treats as being exempt from sales tax, are subject to sales tax. "Final determination" shall mean an assessment by the
Department of Revenue that is no longer subject to protest, or a determination of a court having jurisdiction over such
matters that is final and not subject to appeal. Subcontractor agrees to promptly notify Owner of any audit,
assessment, proposed assessment or notice of deficiency issued with regard to the Project and relating to Owner-
Furnished Materials.
10. As invoices are received, Subcontractor shall be required to review invoices submitted by all suppliers of
Owner-Furnished Materials delivered to the Project during that delivery for use by the Subcontractor and either concur
or object to the Owner's issuance of payment to the suppliers, based upon Subcontractor's records of materials
delivered to the site and any defects in such materials.
11. In order to arrange for the prompt payment to the supplier, the Subcontractor shall provide to the Owner a
listing indicating the acceptance of the goods or materials within fifteen (15) days of receipt of said goods or materials.
The list shall include a copy of all applicable Purchase Orders which will include owner's Certificate of Exemption
number, invoices, delivery tickets, written acceptance of the delivered item, and such other documentation as may be
reasonably required by the Owner. The check will be released, delivered and remitted directly to the supplier. The
Subcontractor agrees to assist the Owner to immediately obtain partial or final release or waivers as appropriate. At the
end of the Project, Subcontractor will be provided with a deductive Change Order for the cost incurred by the Owner to
provide all Owner-Furnished Materials. Salvage materials shall be stored or removed from the site by the
Subcontractor at the Owner's direction, or may be turned over to the Subcontractor for salvage or disposal at the
Subcontractor's option.
ATTACHMENT "C"
From TLC Diversified. Inc. (CONTRACTOR)
To Planet Environmental Systems, Inc. C/OHe)n±ard Florida Inc. (SUBCONTRACTOR)
Project: MARSHALL STREET & EAST- CHLORINE GAS ANDSULFUR DIOXIDE
CONVERSION PROJECT (07-0027-UT)
This project qualifies the Owner to utilize its sales tax exemption for the purchase of materials used in the project. In
order to do this, the City of Clearwater, Florida, (Owner) must pay for the materials directly. This shall be accomplished
in the following manner:
1. Subcontracts will be issued by Contractor to Subcontractors in the usual manner, including sales tax.
2. Subcontractors will prepare their material orders and forward same to Contractor so that City of Clearwater
(owner) purchase orders may be placed for these materials.
3. Contractor will return to the Subcontractor a copy of the City of Clearwater (owner) purchase order on behalf
of the City of Clearwater (Owner). It shall read:
To: Supplier
For: Material per attached Subcontractor order,
4. The material supplier will then bill the City of Clearwater (Owner) c/o "Subcontractor" c/o Contractor.
Subcontractor will approve invoice and send to Contractor who will submit same to City of Clearwater (Owner)
for payment.
5.City of Clearwater (Owner) will then pay the invoice directly and the Subcontractor will be issued a deductive
change order for the amount of the invoice plus sales tax.
It is imperative that the Subcontractor approve the invoices and forward them to Contractor by the 25th of each
month for payment by the 25th of the following month. Those received after the 25th will be processed in the next
month's billing cycle.
ATTACHMENT "D"
PROCEDURE FOR GENERATING SUB-CONTRACTOR DIRECT PURCHASE ORDERS FOR SALES TAX
CREDITS
1. General Contractor will submit requisition for materials with vendor information required (see vendor
application form), item description, quantity if applicable, price, etc. Also included will be the sales tax savings amount.
2. Architect will review the requisition, and forward to the project manager for approval and preparation of
electronic purchase requisition. Requisition must contain project number as well as correct account number.
3. Project Manager will then request requisition approval from the Finance Director.
4. Purchasing will issue purchase order and will mail, fax, or otherwise distribute purchase order as requested.
5. A purchase order summary reportwill be maintained indicating the following: purchase order number, owner
Certificate of Exemption number, vendor, total amount of P.O., total tax savings, amount previously requested, amount
of current request, and remaining balance of P.O. This report will be updated and issued with each group of payment
requests (monthly).
6. Payment requests with invoices must have receiving paperwork with authorized signatures and must be
submitted for approval as indicated below:
7. Payment authorization sequence: invoices must be submitted for approval in the following order:
a. General Contractor
b. Architect
c. Project Manager
d. Engineering/City Manager
e. Purchasing/for processing only
f. Finance/for processing only
PROCEDURES FOR SALES TAX SAVINGS, REQUESTS TO REQUISITION and
RECEIVINGANVOICING
CITY OF CLEARWATER
MARSHALL STREET & EAST APCF CHLORINE GAS AND SULFUR DIOXIDE GAS
CONVERSION PROJECT
PROJECT No. 07-0021-UT
Contractor: TLC Diversified, Inc.
CEI: Jones Edmunds & Associates
Addendum to Agreement for Construction:
See separate instructions for completing the Addendum to Agreement.
Process procedures for tax savings:
2. Completion of the Request to Requisition forms by Contractor.
3. Approved by CEI. Approver(s): Claus Schirk
4. Original to Owner's Representative for processing of P.O. requisition.
5. Based on Request to Requisition forms a schedule will be prepared for the City's Purchasing Manager
to reduce the Contractor's P.O. by the amount of the P.O.s to the Materials Suppliers. It is important
to process as many material supplier Requests to Requisition as possible at one time thereby
reducing the amount of changes necessary to Contractor's P.O. Construction contract will not change
and the sum of the P.O.s to the Materials Suppliers plus the Contractor's P.O will represent the total
contract commitment. Before sending to the Purchasing Manager, the schedule will be
forwarded to the Owner's Representative. CEI and Contractor's representative for approval.
We will need the a-mail address for the Contractor's & CEI's contact person(s) for this
process.
6. The estimated sales tax savings for each materials requisition will be deducted from the primary lines
of Contractor's P.O. A related Sales Tax Savings line for each charge code will be added to the
Contractor's P.O. No changes will be made to the sales tax savings lines until all materials are
purchased, received, accepted and paid for unless additional materials purchases are necessary.
7. Closing of the sales tax savings line on the Contractor's P.O. can only be done through a change
order (Recommendation is that it's done on the final C/O).
Process procedures for request to requisition forms:
1. General description is a brief recap (sewer lines and manholes; water lines; etc)
2. Contractor should include their fax number as well as a contact number.
3. In the description section of the Request to Requisition include any special delivery instructions.
4. Indicate whether or not retainage is to be withheld. City's standard is 5%.
5. Include the address where the supplier is to mail invoices.
6. Where applicable, shipping and handling costs should be listed as a line item on the request to
requisition.
7. City staff will complete the charge code line.
Procedures where a detailed line item ro osal has been received from the ODP su lier:
a. On the request to requisition summarize the materials to be ordered by type of system
(stormwater, streets, water, sewer, reclaimed, etc) giving the total dollar amount per for each
system. Leave 2 line spaces between each system to allow for the addition of the City's charge
code.
b. Attach the supplier's proposal to be mailed as an attachment to the purchase order. Attachment
should include estimated uantities and !ypes of materials. Cost information is optional.
Procedures where a detailed line item proposal is not available:
c. Provide quantities and detailed descriptions of the items to be ordered, per unit and total cost as
the City's P.O. will be sent directly to the Materials Supplier.
d. Materials on each request to requisition should be grouped in relation to the major billing line
items on Contractor's P.O. Leave 2 spaces between each group, as the City will add the
appropriate charge codes.
B. The requesting official will be the Contractor's official with authority to procure materials. Contractor's
authorized procurer(s): Mark Selph
9. The official approving that the materials requested meet the design specifications will be authorized
personnel from the CEI only. Authorized approvers: Claus Schirk
NOTE: An materials ordered b the contractor that are not included on the City's issued purchase
order or an amounts ordered that exceed the amounts on the City issued purchase order MUST
be separately ordered pursuant to a -purchase order direct) between the supplier and the
contractor. These materials MUST be invoiced separately from the materials supplied pursuant to
the City issued purchase order. Another option would be to submit an additional Re guest to
Re uisition to increase the amount of the ODP purchase order for that supplier.
Process proced? res for receiving and invoicing:
1. Upon receipt of materials, Contractor's representative will verify the materials are in usable condition and
the quantity received.
2. The Materials Suppliers will be instructed on the City's P.O. to send their original invoice to the Contractor
to the attention of Ken Van Epps.
3. Contractor must sign off on the invoice to approve the payment and, if no receiving report is attached,
must indicate on the invoice that all materials were received in usable condition. Any discrepancies with
the invoice are to be resolved between the Contractor and the Materials Supplier. If the invoice is in error,
it can be corrected by the Contractor before forwarding for payment under the following conditions:
a. A corrected supplier's invoice can be paid up to the amount of the originally issued invoice but not
in excess of that amount.
b. None of the original data on the invoice can be obliterated. If it is the City will return the invoice
for replacement by a corrected one from the supplier.
c. If the corrections cause the invoice amount to exceed the original billed amount, the excess must
be invoiced separately by the supplier and is to have the same support documentation and/or
approvals as all other invoices to be paid.
4. Supplier invoices for retainage amounts, if any has been withheld, are not required support documentation
but must follow the approval process as all other invoices.
5. After approval the Contractor will forward the original invoice and any attachments to City of Clearwater's
Owner Representative:
City of Clearwater
Engineering Department
Attn: Robert Maue, PE
100 S. Myrtle Avenue, Rm. 220
Clearwater, FL 33756
6. After approval and verification of the materials received the Owner's Representative will forward the
original invoice and any attachments to the appropriate City department for payment processing.
7. Steps 1 through 7 will be followed for each materials receipt and invoice.
8. Materials purchase P.O.s can be closed only upon completion of the materials acquisition and at the
approval of the Contractor.
9. Upon closing of a materials purchase P.O. any unused balance will be added back to the appropriate
line(s) on Contractor's P.O.
Closina of Contractor's P.O.:
1. All Materials Suppliers' P.O.'s must be closed prior to the final change order and closing of the
Contractor's P.O.
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PUBLIC WORKS ADMINISTRATION
REQUEST TO REQUISITION
STANDARD PURCHASE ORDER
General Item Description: Section 11345 Chemical Metering Pump Skids - Marshall St APCF
Vendor : Blue Planet Environmental Systems, Inc. C/O Heyward Florida Incorporated
Attn. Gregory Chomic gchomic@hevwardfl.com
Street Address: 415 Country Club Drive
City/State/Zip: Winter Park, FL 32789
Phone Number: (407) 628-1880
Receiving Location (Ship to): Marshall St. APCF
Street Address: 1605 Harbor Dr.
City/State/Zip: Clearwater, Florida 33755
Requested by: Mark Sel h TLC Diversified, Inc msel h tlcdiversified.com
Phone Number: (941) 722-0621
Date Needed by: Aril 19"', 2010
Expense Code: 0376-96624-563800-535-000-0000
Line #
Quantit Units
$, etc. Detailed Description
List shipping & handling charges, if applicable) Price Per
Each
Total
4a 1 LS Furnish and Deliver Chemical Feed pump
skids for sodium hypochlorite system (Includes
7 Pumps) $ 98,308.01 $ 98,308.01
4b 1 LS Sodium Hypochlorite Feed System Sales Tax
(6% plus $ 5,948.48 $5,948.48
5a 1 LS Furnish and Deliver chemical feed pump skids
for sodium bisulfate system Includes 3 Pumps) $ 33,076.29 $ 33,076.29
5b 1 LS Sodium Bisulfate Feed System Sales Tax (6%
plus $50 $ 2,034.57 $ 2,034.57
10% Retains a Withheld
10% Due Before Delivery
Provide 24hr Notice for delivery
941 722-0621 attn. Ken Van Epps
Total Purchase Order Amount $131,384.30
Total Tax Savings $ 7,983.05
Date: Dated4- dz. 10
Requesting Official /? / Ap ving OfFicia pp
/ C' dP?s?c Q?s?1?C><A M,11ltSTQ?•TGQ •.1000& 1a!?MuNtS
itle and Organization Title and
Completed forms are routed for approval to contracted C.E.&I. Firm and/or to Engineering. Engineering will process and provide records
retention according to City of Clearwater's Records Management Program.
Page 1 of 1
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PUBLIC WORKS ADMINISTRATION
REQUEST TO REQUISITION
STANDARD PURCHASE ORDER
General Item Description: Section 11345 Chemical Metering Pump Skids - East APCF
Vendor : Blue Planet Environmental Systems, Inc. C/O Heyward Florida Incorporated
Attn. Gregory Chomic gchomic@heyWardfl.com
Street Address: 415 Count Club Drive
City/State/Zip: Winter Park, FL 32789
Phone Number: (407) 628-1880
Receiving Location (Ship to):
Street Address: 3141 Gulf tc
City/State/Zip: Clearwater,
Requested by:
Phone Number:
Date Needed by:
Expense Code:
East APCF
Ba Blvd.
Florida 33755
Mark Sel h TLC Diversified, Inc mselph@tlcdiversified.com
941 722-0621
April 19 . 2010
Line #
Quantit Units
y etc. Detailed Description
List shipping & handling charges, if applicable) Price Per
Each
Total
13a 1 LS Furnish and Deliver Chemical Feed pump
skids for sodium hypochlorite system (Includes
4 Pumps) $ 65,161.72 $ 65,161.72
13b 1 LS Sodium Hypochlorite Feed System Sales Tax
6% lus $50 $ 3,959.70 $ 3,959.70
14a 1 LS Furnish and Deliver chemical feed pump skids
for sodium bisulfite system Includes 2 Pumps) $ 32,560.86 $ 32,560.86
14b 1 LS Sodium Bisulfite Feed System Sales Tax (6%
plus $50 $ 2,003.65 $ 2,003.65
10% Retains a Withheld
10% Due Before Delivery
Provide 24hr Notice for delive
941 722-0621 attn. Ken Van Epps
Total Purchase Order Amount $97,722.58
Total Tax Savings $ 5,963.35
Date: 2- o 0 Date: Q4.02-10
Requesting Official ol' pro
r ?A?1'?1P1L1r 4 14%Q1S"VM Jt7 3es. M>MV0ps
itle and Organization Title and
Completed forms are routed for approval to contracted C.E.&I. Firm and/or to Engineering. Engineering will process and provide records
retention according to City of Clearwater's Records Management Program.
Page 1 of 1