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HomeMy WebLinkAboutCORRESPONDENCE - BID - 7658 MISCELLANEOUS CONCRETE ANNUAL (16)Utilities Work Order Form Official Purchasing Form Last updated 10/2017 WORK ORDER PURSUANT TO A MASTER AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND LIGHTFIELD ENTERPRISES, INC WORK ORDER NUMBER: U2018-005 PROJECT TITLE: UInlet Asset Replacement in Boltz and Skyway Area Relating to Opportunity Projects with the Streets Maintenance Program ORIGINAL BID/RFP NUMBER & NAME: U7658, Misc. Concrete MASTER AGREEMENT EFFECTIVE DATE: UJuly 15, 2014 ARCHITECT/ENGINEER: UNA OWNER’S REPRESENTATIVE: UDouglas Groves WORK ORDER COMMENCEMENT DATE: UOctober 22, 2018 WORK ORDER COMPLETION DATE: UDecember 15, 2018 MAXIMUM FEE: (time and reimbursable direct costs): U$33,045.72 PROJECT DESCRIPTION/SCOPE OF SERVICES: UBoltz Area: Remove curb gutter and sidewalk, construct four (4) metal sidewalk culverts, reconstruct one (1) Type R inlet deck, including expansion and caulking, thirty (30) LF drive over curb gutter & Sidewalk and aggregate base. Skyway: Remove and replace two (2) Type R inlets, including curb & gutter, six-inch (6”) flatwork, aggregate base, expansion and caulking and traffic control. This work order includes twenty-percent (20%) construction contingency. See attached supporting documentation. Service Provider agrees to perform the services identified above and on the attached forms in accordance with the terms and conditions contained herein and in the Master Agreement between the parties. In the event of a conflict between or ambiguity in the terms of the Master Agreement and this Work Order (including the attached forms) the Master Agreement shall control. The attached forms consisting of UtwoU (2) pages are hereby accepted and incorporated herein, by this reference, and Notice to Proceed is hereby given after all parties have signed this document. Page 1 of 6 DocuSign Envelope ID: 51AB6683-4982-4505-BB93-0654C8A57D15 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 SERVICE PROVIDER: Lightfield Enterprises, Inc. By: Date: Name: Title: Page 2 of 6 DocuSign Envelope ID: 51AB6683-4982-4505-BB93-0654C8A57D15 Executive Vice President October 22, 2018 Keith Lightfield Utilities Work Order Form Official Purchasing Form Last updated 10/2017 OWNER’S ACCEPTANCE & EXECUTION: This Work Order and the attached Contract Documents are hereby accepted and incorporated herein by this reference. ACCEPTANCE: Date: Douglas Groves, Stormwater Maintenance Operations Manager REVIEWED: Date: Dale Elliot, Senior Buyer APPROVED AS TO FORM: Date: Name,City Attorney's Title (if greater than $1,000,000) ACCEPTANCE: Date: Andrew Gingerich, Civil Engineer III ACCEPTANCE: Date: Theresa Connor, Utilities Deputy Director ACCEPTANCE: Date: Kevin Gertig, Utilities Executive Director (if greater than $1,000,000) ACCEPTANCE: Date: Gerry Paul, Purchasing Director (if greater than $60,000) ACCEPTANCE: Date: Darin Atteberry, City Manager (if greater than $1,000,000) ATTEST: Date: City Clerk (if greater than $1,000,000) Page 3 of 6 DocuSign Envelope ID: 51AB6683-4982-4505-BB93-0654C8A57D15 October 22, 2018 October 22, 2018 October 22, 2018 October 25, 2018 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT A WORK ORDER COST AND SCOPE DETAIL Page 4 of 6 DocuSign Envelope ID: 51AB6683-4982-4505-BB93-0654C8A57D15 Estimate Date 9/11/2018 Estimate # C1586 Bill To: City of Fort Collins Stormwater Attn: Doug Groves P.O. Box 580 Fort Collins, Co. 80522 Project Location Boltz Area P.O./ Work order # Terms Net 30 Representat... CH Phone # 9704843880 Fax # 970-416-6230 E-mail smagdaleno@lightfieldenterprises.com Total We propose to furnish material and labor-complete in accordance with the above specifications. All work to be completed in a professional manner and in accordance with industry standards. Any alteration or deviation from above specifications must be done in writing. Estimate is good for 30 days. Acceptance of Proposal: The above prices, specifications and conditions are satisfactory and are hereby accepted. Lightfield Enterprises is authorized to do work as specified. I agree to pay as outlined in the "Terms" stated above. 2600 Midpoint Drive Fort Collins CO 80525 Description QtyUnit Cost Total Remove Monolithic Curb, Gutter & Sidewalk 195 SF 3.89 758.55 Metal Sidewalk Culvert - 2' Opening, Remove & Replace 4 EA 625.00 2,500.00 Metal Sidewalk Culvert - 2' Opening, Materials Only 4 EA 2,130.00 8,520.00 Reconstruct Type R Inlet Deck – Remove and Replace 1 EA 1,286.25 1,286.25 Expansion and Caulking 65 LF 4.15 269.75 Driveover Curb, Gutter & 6" Sidewalk 30 LF 44.10 1,323.00 Aggregate Base Course/Recycled Concrete Base = 5 Tons 5 TN 40.95 204.75 $14,862.30 Page 5 of 6 DocuSign Envelope ID: 51AB6683-4982-4505-BB93-0654C8A57D15 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT B CERTIFICATE OF INSURANCE CONTRACTOR shall submit Certificate of Insurance in compliance with the Contract Documents. Page 6 of 6 DocuSign Envelope ID: 51AB6683-4982-4505-BB93-0654C8A57D15 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME: CONTACT (A/C, No): FAX E-MAIL ADDRESS: PRODUCER (A/C, No, Ext): PHONE INSURED COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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). 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 INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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 CONTRACT OR 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. $ $ $ PROPERTY DAMAGE $ BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT ER OTH- STATUTE PER (MM/DD/YYYY) LIMITS POLICY EXP (MM/DD/YYYY) POLICY EFF LTR TYPE OF INSURANCE POLICY NUMBER INSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE $ $ OCCUR CLAIMS-MADE DED RETENTION $ PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $ EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 5/25/2018 The Harry A. Koch Co. P.O. Box 45279 Omaha NE 68145-0279 402-861-7000 National Union Fire Ins Co. of Pitt 19445 LIG46636 New Hampshire Ins Company 23841 Lightfield Enterprises 2600 Midpoint Drive Fort Collins CO 80525 1320078047 A X 1,000,000 X 50,000 5,000 1,000,000 2,000,000 X 3506965 6/1/2018 6/1/2019 2,000,000 A 1,000,000 X 4544903 6/1/2018 6/1/2019 B 25893880 6/1/2018 6/1/2019 X 1,000,000 1,000,000 1,000,000 RE: Miscellaneous Concrete Contract (Bid# 7658). Certificate holder is additional insured for General Liability and Auotmobile Liability if required by written contract executed prior to loss. City of Fort Collins Purchasing Division PO Box 580 Fort Collins CO 80522 DocuSign Envelope ID: 51AB6683-4982-4505-BB93-0654C8A57D15