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HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 9190942Utilities Work Order Form Official Purchasing Form Last updated 10/2017 WORK ORDER PURSUANT TO A MASTER AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND CTL THOMPSON, INC WORK ORDER NUMBER: USherwood 2019-04 PROJECT TITLE: USherwood St. Waterline ORIGINAL BID/RFP NUMBER & NAME: U8413, Geotechnical Testing Services On- Call MASTER AGREEMENT EFFECTIVE DATE: UJanuary 1, 2017 ARCHITECT/ENGINEER: UDitesco Services, Inc. OWNER’S REPRESENTATIVE: UHeather McDowell WORK ORDER COMMENCEMENT DATE: UJune 10, 2019 WORK ORDER COMPLETION DATE: UAugust 2, 2019 MAXIMUM FEE: (time and reimbursable direct costs): U$5,530.00 PROJECT DESCRIPTION/SCOPE OF SERVICES: USoils and material testing for Sherwood St. Waterline replacement. 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: CTL Thompson, Inc. By: Date: Name: Title: Page 1 of 6 DocuSign Envelope ID: 5B5E2A16-6BF2-4733-A137-59E08F232B21 Heather Grubb Field Department Manager May 20, 2019 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: Heather McDowell, Civil Engineer III REVIEWED: Date: Elliot Dale, Senior Buyer APPROVED AS TO FORM: Date: Name,City Attorney's Title (if greater than $1,000,000) ACCEPTANCE: Date: Matt Fater, 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 6 DocuSign Envelope ID: 5B5E2A16-6BF2-4733-A137-59E08F232B21 May 20, 2019 May 20, 2019 May 23, 2019 May 20, 2019 May 23, 2019 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT A WORK ORDER SCOPE OF SERVICES & COST DETAIL Page 3 of 6 DocuSign Envelope ID: 5B5E2A16-6BF2-4733-A137-59E08F232B21 400 North Link Lane | Fort Collins, Colorado 80524 Telephone: 970-206-9455 Fax: 970-206-9441 May 10, 2019 City of Fort Collins Utilities Department 700 Wood Street Fort Collins, Colorado 80521 Attention: Matt Fater, P.E. Subject: Fee Estimate for Construction Observation and Materials Testing Services Sherwood Street Waterline Project Fort Collins, Colorado Fee Estimate No. FC 19-0189 At your request, CTL|Thompson, Inc. is pleased to provide this fee estimate for Construction Observation and Materials Testing services for the Sherwood Street Waterline project located in Fort Collins, Colorado. We used the testing quantities and plans that were provided in preparation of our proposal. We understand that the city will use our estimate for the basis of establishing a budget for the project and to issue a purchase order for our services. Our estimated scope of services and associated fees were prepared according to the terms and conditions of our professional services agreement with the City of Fort Collins and are presented below. Testing is to be completed on an as needed basis during construction between June 17 and July 26th. Soil Compaction Testing: Compaction testing for waterline trench backfill and aggregate base course will be necessary. We estimate 15 days of 2 site visits per day will be necessary. Soil Compaction Testing 15 days x 3 hrs/day x $70/hr $3,150.00 Proctor Test 3 tests x $100/test $300.00 Gradation Test 3 tests x $50/test $150.00 Atterberg Limits Test 3 tests x $70/test $210.00 Subtotal: $3,810.00 Asphalt Testing: Asphalt testing on will be necessary. We estimate 2 days of paving will be necessary. AC/Gradation Test 2 tests x $170/test $340.00 Max Theoretical Density Test 2 tests x $90/test $180.00 Asphalt Testing 2 days x 6 hrs/day x $70/hr $840.00 Subtotal: $1,360.00 Page 4 of 6 DocuSign Envelope ID: 5B5E2A16-6BF2-4733-A137-59E08F232B21 CITY OF FORT COLLINS SHERWOOD STREET WATERLINE CTL | T FEE ESTIMATE NO. FC-19-0189 2 Concrete Testing: Concrete testing may be required for the sidewalk and curb replacement. We estimate 2 tests will be required. Concrete Tests 2 tests x $180/test $360.00 Subtotal: $360.00 TOTAL ESTIMATED FEE: $5,530.00 It should be emphasized that this estimate is based upon assumptions of actual quantities and contractor’s schedule. The fee will be charged only for the actual hours and unit rates presented for tests and observations requested by the owner, contractor or subcontractors who schedule the services. If we can be of further assistance, please contact us at your convenience. Very truly yours, CTL | THOMPSON, INC. Heather Grubb Field Department Manager Page 5 of 6 DocuSign Envelope ID: 5B5E2A16-6BF2-4733-A137-59E08F232B21 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: 5B5E2A16-6BF2-4733-A137-59E08F232B21 INSR ADDL SUBR LTR INSR WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: PHONE FAX (A/C, No, Ext): (A/C, No): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXP TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE INSURER(S) AFFORDING COVERAGE NAIC # Y / N N / A (Mandatory in NH) ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ PRO- OTHER: JECT LOC COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS AUTOS ONLY HIRED PROPERTY DAMAGE $ AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under SAGITTA 25.3 (2016/03) DESCRIPTIONS (Continued from Page 1) The General Liability, Automobile Liability, Umbrella/Excess insurance applies on a primary and non contributory basis. A Blanket Waiver of Subrogation applies for General Liability, Automobile Liability, Umbrella/Excess Liability and Workers Compensation. The Umbrella / Excess Liability policy provides excess coverage over the General Liability, Automobile Liability and Employers Liability. Please note that Additional Insured status does not apply to Professional Liability or Workers' Compensation. 2 of 2 #S23974775/M23955046 DocuSign Envelope ID: 5B5E2A16-6BF2-4733-A137-59E08F232B21 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ POLICY NON-OWNED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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. 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 any rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ACORDTM CERTIFICATE OF LIABILITY INSURANCE Travelers Property Cas. Co. of America Travelers Indemnity Company Pinnacol Assurance Company Starr Surplus Lines Insurance Company Charter Oak Fire Insurance Company 9/28/2018 USI Colorado, LLC Prof Liab P.O. Box 7050 Englewood, CO 80155 800 873-8500 800 873-8500 CTL / Thompson Materials Engineers, Inc. 7306 S. Alton Way Centennial, CO 80112 25674 25658 41190 13604 25615 A X X X X X 6806H199682 10/01/2018 10/01/2019 1,000,000 1,000,000 10,000 1,000,000 2,000,000 2,000,000 E X X X X X 8101175R522 10/01/2018 10/01/2019 1,000,000 B X X X 10000 X X CUP3C002974 10/01/2018 10/01/2019 8,000,000 8,000,000 C N X 180512 10/01/2018 10/01/2019 X 500,000 500,000 500,000 D Professional Liab Incl. Pollution Claims Made SLSLPRO12153618 10/01/2018 10/01/2019 $2,000,000 per claim $4,000,000 annl aggr. As required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The Certificate Holder and owner are included as Automatic Additional Insured's for ongoing and completed operations under General Liability; Designated Insured under Automobile Liability; and Additional Insureds under Umbrella / Excess Liability but only with respect to liability arising out of the Named Insured work performed on behalf of the certificate holder and owner. (See Attached Descriptions) FOR PROPOSAL PURPOSES 1 of 2 #S23974775/M23955046 Client#: 1082473 CTLTHO SBCZP 1 of 2 #S23974775/M23955046 DocuSign Envelope ID: 5B5E2A16-6BF2-4733-A137-59E08F232B21