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HomeMy WebLinkAboutCORRESPONDENCE - BID - 7658 MISCELLANEOUS CONCRETE ANNUAL (29)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: U2019-001 PROJECT TITLE: UFossil Creek Meadows Project 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: UJanuary 22, 2019 WORK ORDER COMPLETION DATE: UFebruary 15, 2019 MAXIMUM FEE: (time and reimbursable direct costs): U$9,294.06 PROJECT DESCRIPTION/SCOPE OF SERVICES: UComplete concrete repairs and concrete headwall for the Fossil Creek Meadows Project. 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 Utwo U (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. SERVICE PROVIDER: Lightfield Enterprises, Inc By: Date: Name: Title: Page 1 of 8 DocuSign Envelope ID: 83E42927-7723-4E06-934A-989D06577910 Keith R. Lightfield January 22, 2019 Executive Vice President 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, Drainage 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, Director – Water Field Services ACCEPTANCE: Date: Theresa Connor, Deputy Director -Water Engineering & Field Services 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 2 of 8 DocuSign Envelope ID: 83E42927-7723-4E06-934A-989D06577910 January 22, 2019 January 22, 2019 January 24, 2019 January 24, 2019 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT A WORK ORDER COST & SCOPE DETAIL Page 3 of 8 DocuSign Envelope ID: 83E42927-7723-4E06-934A-989D06577910 Estimate Date 1/17/2019 Estimate # C1683 Bill To: City of Fort Collins Stormwater Attn: Doug Groves P.O. Box 580 Fort Collins, Co. 80522 Project Location Fossil Creek Pkwy P.O./ Work order # Terms Net 30 Representat... CH We look forward to hearing from you! 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. Date of acceptence________________________Signature_____________________________________________ 2600 Midpoint Drive Fort Collins CO 80525 Description QtyUnit Cost Total Reinforcing Steel 135 lbs 2.30 310.50 Non-reinforced Concrete Wall - 8" 125 sf 17.33 2,166.25 Valley Pan - 6" 80 sf 7.61 608.80 Vertical Curb and Gutter - No Sidewalk 44 lf 28.35 1,247.40 Pedestrian Access Ramp 242 sf 8.03 1,943.26 Aggregate Base Course/Recycled Concrete Base = 5 Tons 10 tn 40.95 409.50 Excavation - General Less Than 50 CY 6 cy 49.35 296.10 Expansion and Caulking 12 lf 4.15 49.80 Truncated Dome Panel 20 sf 52.75 1,055.00 Imported Topsoil 4 yd 32.81 131.24 Asphalt Paving Preservation 40 lf 5.78 231.20 $8,449.05 Page 4 of 8 DocuSign Envelope ID: 83E42927-7723-4E06-934A-989D06577910 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT B WORK ORDER SCHEDULE DETAIL Page 5 of 8 DocuSign Envelope ID: 83E42927-7723-4E06-934A-989D06577910 January 22, 2019 January 28, 2019 Project Notice to Proceed Project Construction Project Final Completion/Acceptance Schedule for Concrete Structures on Lake Canal Access Road Project Page 6 of 8 DocuSign Envelope ID: 83E42927-7723-4E06-934A-989D06577910 February 15, 2019 D Page 7 of 8 DocuSign Envelope ID: 83E42927-7723-4E06-934A-989D06577910 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT C CERTIFICATE OF INSURANCE CONTRACTOR shall submit Certificate of Insurance in compliance with the Contract Documents. Page 8 of 8 DocuSign Envelope ID: 83E42927-7723-4E06-934A-989D06577910 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: 83E42927-7723-4E06-934A-989D06577910