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HomeMy WebLinkAboutCORRESPONDENCE - RFP - 8745 CONSULTING ENGINEERING SERVICES FOR FUTURE WATER, WW & STORMWATER FACILITIES CAPITAL IMPROVEMENTSUtilities Work Order Form Official Purchasing Form Last updated 10/2017 WORK ORDER PURSUANT TO A MASTER AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND MERRICK & COMPANY WORK ORDER NUMBER: UMerrick-SCP-CPABConstSurvey-051519 PROJECT TITLE: UConstruction Survey for Cathodic Protection AB Water Line Construction ORIGINAL BID/RFP NUMBER & NAME: U8745, Consulting Engineering Services for Future W/WW & Stormwater Facilities Capital Improvements MASTER AGREEMENT EFFECTIVE DATE: UJuly 25, 2018 ARCHITECT/ENGINEER: UNA OWNER’S REPRESENTATIVE: USue Paquette WORK ORDER COMMENCEMENT DATE: UMay 15, 2019 WORK ORDER COMPLETION DATE: UNovember 30, 2019 MAXIMUM FEE: (time and reimbursable direct costs): U$6,200.00 PROJECT DESCRIPTION/SCOPE OF SERVICES: USurveying services for the cathodic protection program project, AB Water Line CP, construction survey to include surveying underground utilities, data processing, drafting and construction locations staking. See the 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. SERVICE PROVIDER: Merrick and Company By: Date: Name: Title: Page 1 of 7 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 Ken Matthews April 22, 2019 Water Practice Leader 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: Sue Paquette, Civil Engineer III REVIEWED: Date: Pat Johnson, Senior Buyer APPROVED AS TO FORM: Date: Name,City Attorney's Title (if greater than $1,000,000) ACCEPTANCE: Date: Owen Randall, Director - Civil Engineering ACCEPTANCE: Date: Andrew Gingerich, Director – Water Field Operations 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 7 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 April 19, 2019 April 21, 2019 April 22, 2019 April 22, 2019 April 22, 2019 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT A WORK ORDER SCOPE & COST OF SERVICES Page 3 of 7 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 Page 4 of 7 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT B WORK ORDER SCHEDUE DETAIL Page 5 of 7 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 2019 May June July August September October November Project Notice to Proceed Project Construction Project Substantial Completion Project Final Acceptance Schedule for Merrick Construction Survey AB Line Cathodic Protection Project Page 6 of 7 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 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 7 of 7 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 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? ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: 2 2 Denver Waiver of subrogation is applicable where required by written contract and subject to policy terms and conditions. � This insurance is primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured subject to policy terms and conditions. � Notice of Cancellation is included per the attached endorsements.�� �� �� Certificate Holder(s) is/are included as additional insured for General Liability and Auto Liability where required by written contract with respect to operations of the Named Insured. � � Certificate of Liability Insurance CN101829745 MARSH USA INC.� 5970 Greenwood Plaza Blvd.� Merrick & Company� Greenwood Village, CO 80111 25 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743 (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) © 1988-2016 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY A 1,000,000 03/01/2020 57UUNZC2767 Jon Lindstrom X SEA-003565876-03 1,000,000 3,000,000 57WEVK1120 (MO,NC,SC,TX) X 29459 3,000,000 Retention of Marsh USA Inc. Attn: Denver.CertRequest@marsh.com N 03/01/2019 X 1 03/01/2020 03/01/2019 19437 03/01/2020 57UUNZC2767 Professional & Pollution Liab. B 2,000,000 19682 1,000,000 X N/A Twin City Fire Insurance Company 1,000,000 X D X 02/22/2019 IE 500,000 03/01/2019 2,000,000 City of Fort Collins is included as additional insured (except workers compensation, and professional/pollution liability) where required by written contract. This insurance is primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured and where required by written contract. Waiver of subrogation is applicable where required by written contract. X 03/01/2019 PO Box 580 Fort Collins, CO 80522 City of Fort Collins Lexington Insurance Company 10,000 A Hartford Fire Insurance Company N/A CN101829745-STND-GAWUE-19- Per Claim/Aggregate 10,000 03/01/2020 1,000,000 57RHUFM3402 Shared Limits - Claims Made A 2,000,000 29424 1,000,000 1,000,000 03/01/2020 57WEVK1120 (AOS) 1225 17TH STREET, SUITE 1300 MARSH USA INC. X DENVER, CO 80202-5534 5970 Greenwood Plaza Blvd. Merrick & Company Greenwood Village, CO 80111 X X 015448988 03/01/2019 Owen Randall 03/01/2019 F 03/01/2020 Hartford Casualty Ins Co DocuSign Envelope ID: 03526191-2CAC-4BDA-AD73-C139BE6DC743