Loading...
HomeMy WebLinkAboutWORK ORDER - RFP - 7637 GENERAL CONTRACTOR FOR FIRE STATION EXPANSION & RENOVATION PROJECTSEXHIBIT "A" WORK ORDER FORM PURSUANT TO AN AGREEMENT BETWEEN THE CITY OF FORT COLLINS ACTING AS AGENT FOR POUDRE FIRE AUTHORITY AND BRINKMAN CONSTRUCTION DATED: July 15, 2014 Work Order Number: Station 5-2014-2 Poudre Fire Authority Board Resolution Number: 14-9 Project Title: Station 5-Asphalt Shingle.Re-Roof Commencement Date: August 26, 2014 Completion Date: November 30, 2014 Maximum Fee: (time and reimbursable direct costs): $39,318.65 Purchase Order # Project Description: Re -shingle existing sbingled roof areas. As defined in the attached proposal from Brinkman Construction dated August 20, 2014, project name Station 5-Asphalt Shingle Re -Roof. Acceptance Poudre Fire Authori Service Provider agrees to perform the services identified above and on the attached forms in accordance with the terms and condition_ s contained herein and in the Services Agreement between the parties. In the event of a conflict between or ambiguity in the terms of the Services Agreement and this work order (including the attached forms) the Services Agreement shall control. Date: Service ovi r By: Date: ';J./'zo The attached fortes consisting of two (1) page are hereby accepted and incorporated herein by this reference, and Notice to Proceed is hereby given. 4/2001 B R I N K M AN Poudre Fire Authority -Work Order Proposal OONYCTrON PROJECT NAME: Station 5 - Asphalt Shingle Re -Roof WORK ORDER Ji: ST.J rl ow J —Z o/ g —,;I PROJECT ADDRESS: 461E Hogan Drive Fort Collins, CO Date: 8.20.14 C ANGEREQU SILDIESCRI'73N Furnish and install asphalt shingle roofing, sheet metal 8ashings, gutters and downspouts per attached Front Range Roofing Systems proposal and scope of work dated 8.19.14, ` r. i k SUBCONTRACTOR SCOPE.a "-'s� d7`W§:'ti"..' ..u^ E, '. a UNITWO �ti."u StRA Fd.9r.SSt. i4.`IktYdl Front ange oo ng Asphalt Shinale-Roofl &'Sheet Nleta 1 S259 Front R e Roofi Add opton for W year class IV'unpact resistance 1 LS $ 1,750.00 $ 1.750.00 Front R e Roofi Add option for new gutters and downspouts 1 LS $ 4.200.00 It 4.200.00 BCI Senior Superintendent - 20 - HRS 3 -80.00 $ 1,500.00 BCI Senior Project Manager 5 HRS $ . 80.00 $ 400.00 SCI - P 'act Coordinator 3 HRS $ 46.00 $- 135.00 BCI PrcjectAccoumtant 2 HRS $ 50.00 $ 100.00 BCI Safety - 1 LS $ 250.00 $ 250.00 Gallegos Portable toilet 2 WKS $ 120.00 $ - 240.00 City of Fort Cot s Permit Allowance 1. LB $ 600.00 $ 6 00 a $ Exclusions: Stone piping improvements at downspout drainage problem SUBTOTAL COSTS $ 35,195.00 CONTINGENCY 5.00% $ 1,759.75 INSURANCEF--0-85—%--1 $ 314.12 CONTACTOR OH&P 5.5% $ 2,049.79 REQUESTgTOTALi .sF—R39`3%16, Estimated Duration: 2 weeks Lead fime & material procurement: 2 w 3 weeks Poodle Fire Authority. Brinkman Construction, In/cJ Signature: Signature: Date Date: $. 2 �• T. DocuSign Envelope ID: 3934D3DA-5E4B4 DBE-8381-A264DBB4A9DB BRIC03 iACORDn. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 7/1412014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE. HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Flood & Peterson lns.,Inc. P. O. BOX 578 CONTACT Sandy Schifferns uc°NN at,970 266.7107 uC N„ 970 506-6845 EAIAIL 00P SS: sschifferns fld eterson.com ADDRESS, ADDRE Greeley, CO 80632 970 356-0123 . - INSURER(S)AFFORDINGCOVERAGE NAIC# INSURER A: The Cincinnati Insurance Ciompan INSURED INSURER B: Starr Technical Rick Insurance Brinkman Construction, Inc. 3003 E. Harmony, Suite 300 Fort Collins, CO 80528 INSURER C Pinnacol Assurance INSURERD: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE ADDLSUBR NSR MD POLICY NUMBER MMIDIDmYY MMIDDNYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS�MADE1:9 OCCUR X PD Ded;21500 CPP0191182 .. -. 2/17/201402117/201 EACH $1000000 �OCCURRENCE PREMISES Eao�anam. $300000 MED EXP(Any one person) $5000 PERSONAL IT ADV INJURY -$1 00O 000 GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPLIES PER:_... PRO- LOC POLICY JF PRODUCTS-COMP/OPAGG $2,000,000 $ A ANYAUTO ALL OWNED SCHEDULED AUTOS S AUTOHIRED AUTOS X UTOS NON-OWNED A CPP0191182 '' 21171201402/17/201 COMEeaBINEDSINGLELIMIT1,OOQ000 IOMOBILELIABILITY,. BODILY INJURY(Per person) $ BOOILV INJURY (Per acaccident)$ PROPERTY tDAMAGE Per acciden $ $ B X UMBRELLA LIAR EXCESS LIAB X OCCUR CI -AIMS MADE 1000020715 2/17/2014 02117/2011 EACH OCCURRENCE s5,000,000 AGGREGATE s5,000.000 DED I X RETENTION$0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTNE OFFICEWMEMBER EXCLUDED'! � (Mandatory In NH) If yes. deacrihe under DESCRIPTION OF OPERATIONS below N I A 4093547 6/0112014 061011201 WC 5TATU- OTH- 1QRYLIMU5 1. E.L. EACH ACCIDENT $1000g00 E.L. DISEASE -EA EMPLOYEE $1000000 EL DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) City of Fort Collins and Poudre Fire Authority, their officers, agents and employees are included as Additional Insured on general liability and auto liability as required by written contract with respects to liability arising out of work performed by the named insured. City of Fort Collins and Poudre Fire Authority P.O. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2010105) 1 of 1 #S9134001M894670 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MZS