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HomeMy WebLinkAboutCORRESPONDENCE - BID - 8844 MISCELLANEOUS CONCRETE (35)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: U2019-0930 PROJECT TITLE: UStoney Creek Stormwater Inlet 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: UOctober 7, 2019 WORK ORDER COMPLETION DATE: UNovember 15, 2019 MAXIMUM FEE: (time and reimbursable direct costs): U$7,956.56 PROJECT DESCRIPTION/SCOPE OF SERVICES: UConstruct two (2) inlet decks on a pre-cast 10-foot Type R inlet and various concrete repair work, including traffic control, flagging hours, dump fees, temp patching, base materials, backfill and top soil. Actual cost will be invoiced at contract unit pricing. 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 UthreeU (3) 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 9 DocuSign Envelope ID: AA826388-F240-49DB-99A3-CFC5CD01E6AD Keith Lightfield Executive Vice President October 15, 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: Douglas Groves, Drainage Operations Manager REQUISTION ENTERED Date: Melissa Walker, Finance Coordinator REVIEWED: Date: Elliot Dale, 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 9 DocuSign Envelope ID: AA826388-F240-49DB-99A3-CFC5CD01E6AD October 11, 2019 October 14, 2019 October 15, 2019 October 16, 2019 October 17, 2019 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT A WORK ORDER COST & SCOPE DETAIL Page 3 of 9 DocuSign Envelope ID: AA826388-F240-49DB-99A3-CFC5CD01E6AD 202.04 Sawcut Concrete/Asphalt (8" ≤ 10") 202.08 Remove Monolithic Curb, Gutter & Sidewalk 202.09 Remove Concrete Driveway/Apron/Crosspan 604.13 Reconstruct Type R Inlet Deck – Remove and Replace 608.01 Driveover Curb, Gutter & 6" Sidewalk 608.19 Crosspan - 8" 608.20 Valley Pan - 6" 608.43 Expansion and Caulking SUB TOTAL COST 25% CONTINGENCY FOR Traffic Control Devices, Flagging Hours, Dump Fees, Temp Patching, Base Material, Backfill, Top Soil. Actual costs will be invoiced at contractual unit prices. SUB TOTAL COST COST ESTIMATE for Stoney Creek Stromw Item No. Description Page 4 of 9 DocuSign Envelope ID: AA826388-F240-49DB-99A3-CFC5CD01E6AD Lineal Foot $ 5.75 35.00 $ 201.25 Square Foot $ 3.85 40.00 $ 154.00 Square Foot $ 3.75 120.00 $ 450.00 Each $ 1,250.00 2.00 $ 2,500.00 Lineal Foot $ 42.00 40.00 $ 1,680.00 Square Foot $ 8.50 120.00 $ 1,020.00 Square Foot $ 7.50 40.00 $ 300.00 Lineal Foot $ 4.00 15.00 $ 60.00 $ 6,365.25 25% $ 1,591.31 $ 7,956.56 water Inlet Project UNITS TOTAL 2019 Revised Unit Price Unit Page 5 of 9 DocuSign Envelope ID: AA826388-F240-49DB-99A3-CFC5CD01E6AD Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT B WORK ORDER SCHEDULE DETAIL Page 6 of 9 DocuSign Envelope ID: AA826388-F240-49DB-99A3-CFC5CD01E6AD 10/7/2019 10/21/2019 11/8/2019 Project Notice to Proceed Project Construction Project Final Completion/Acceptance Schedule for Stoney Creek Stormwater Inlet Project Page 7 of 9 DocuSign Envelope ID: AA826388-F240-49DB-99A3-CFC5CD01E6AD 11/15/2019 Page 8 of 9 DocuSign Envelope ID: AA826388-F240-49DB-99A3-CFC5CD01E6AD 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 9 of 9 DocuSign Envelope ID: AA826388-F240-49DB-99A3-CFC5CD01E6AD 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 5/23/2019 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 188554515 A X 1,000,000 X 300,000 25,000 1,000,000 2,000,000 X X Y 3506965 6/1/2019 6/1/2020 2,000,000 A 1,000,000 X 4544903 6/1/2019 6/1/2020 B X N 25893880 6/1/2019 6/1/2020 1,000,000 1,000,000 1,000,000 RE: Miscellaneous Concrete Contract (Bid# 8844). 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: AA826388-F240-49DB-99A3-CFC5CD01E6AD