TASK ORDER FORM FOREST RIVER PK (fur all on-call vendors any amount and CITY OF SALEM
for trade T.O. over S10k) TASK ORDER(T.O.)FORM l
1.Contract Information Use a unique/sequestlonal number
On Call Contract Number: 20-22-230 T.O.Request Number: Contract Expiration Date: 11/30/2020
(1/a!19W a n/a)
Vendor Name Weston&Sampson Services,Inc. ID 5522
2.Task Order Services
a.Requested By Engineering (Department)
b.Project Name Forest River Tide Gate Repair Unique ID n/a (if trade repair N/A)
c.Summary of Services: Short overview of work,location and why.
Replace gate shaft and gate electronic actuators on tide gate at Forest River tide gate station located at 478 Lafayette Street,
d. Attachments: Attach documentation that includes specifics services,team,cost,etc.Summarize ott below. If trade over
SlOk,list 3 vendors solicited,and attach quotes received.
see attached
e.Changes to On-Call Contract Base Terms Applicable to Only this Task Order.Must provide redline version of on-call with changes.list
sections affected below
f. Total Task Order Cost 579,000 (The P.O.should be for this amount)
g.Task Order Completion Date 8/1/2020(Mayor's signature is start date,put in dote of completion
of services)
h.Does this T.O.change on existing task order. no Yes or No If Yes,fill in below.if no,skip to Section 3.
This is just for informational purposes only
If yes,which Task Order It Prior to requesting o task order,ensure that
Original Task Order Cost funds ore ovoiloble to cover the cost.Fill in blue
%Increase from Original Task Order Cost areas. Green automaticolly calculates or
should not change for each co. Project
Original Completion Date Summary tab used for on-call information and
Requested change in Date in days tracking T.O.'s Need new robs,just copy and
rename.
3.Approved By: City Project Manager Initial Here dhk Name-Print david knowiton
This task order shall be attached and mode port of the On Coll Contract referenced above between the Vendor and the Owner(City of Salem) This
task order approves scope,schedule,cost,and payment of services. All other terms,conditions,and services pursuant to the contract referenced
above ore In full effect unless opproved in Section 2e above if terms of this task order conflict with the on-coli contract referenced in Section 1 above,
then the on-call contract shall govern unless approved in section 2e above.The scope includes prevailing wages(or Davis Bacon)as applicable by low
i understand this fully executed T.O.is not valid without on approved purchase order.
On Call Contractor/Vendor Otyof Salem
Pais., e'6 4 _ Mayor Kimberley Driscoll Date
President
Signature Title
Finance Director Date
Peter J.Koloklthas,P.E. Laurie Giordella
Print Name
Date January 10,2020 Purchasing Agent Date
Torn Watkins
Internal Use Only-If change in use or decrease in cost,no P.O.needed
Req. k r.Ic�., ‘I (i,5 n/ i- 'i')3 - 5�(r�3 FApprov `-
FunO ng�Account MO��I C 441(411f. s , 704Y Soo -171616 v Solt Elizabeth A nnard Date*Op"
Status of T.O Approved ej ted► ect n state why) cf" W1&
Davi -.Knowlton,P.E. Date
1
4 t irt'1?
City of Salem Approved Form Updated 11.18
CITY OF SALEM, MASSACHUSETTS
(orlwr� ASSESSING DEPARTMENT
,p 93 WASHINGTON STREET
n Mr.
-�'�� iii SALEM, MA 01970
C� TEL. 978-745-9595
FAX. 978-744-2069
ASSESSORS@SALEM.COM
MAYOR DIRECTOR
KIMBERLEY DRISCOLL DEBORAH A. JACKSON
BOARD OF ASSESSORS
ROBERT F. MILLERICK
October 2020 RICHARD W. JAGOLTA,JR.
7, TINA ZELANO
Ilene Simons
City Clerk
City Hall
Salem, MA 01970
Dear Ms. Simons:
RE: Residential unit mailing addresses for 217-221 Essex Street
Map 35 Lot 0251
The residential apartments are going to have a mailing address at 2 Derby
Square because the main entryway will be in the back of the building on Derby
Square, not Essex Street. There will be an entry/exit on Essex Street for
emergency services. The apartments/units will be numbered as follows:
Second floor unit #201 - 206 Third floor unit #301-306
Forth floor unit #401 —404 Fifth floor unit #501 —504
Please be-advised that the commercial unit numbers will stay the same as
already noted in our system.
Ve• tr/ y/ s,
PA
Deborah A Jackson
Director of Assessing
Cc: Postmaster
Chief Jerry Guinta, Fire Dept.
Eric Duffy, Water Dept.
Thomas St.Pierre, Building Inspector
Captain Dennis King, Police Dept. 911 Officer
John Giardi , Electrical
Paul Nutting MassGIS notify911address@state.ma.us