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HomeMy WebLinkAboutCORRESPONDENCE - RFP - 8413 GEOTECHNICAL SERVICES ON-CALL (6)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 CTL THOMPSON, INC WORK ORDER NUMBER: URem-CTL-1 PROJECT TITLE: URemington Street Stormwater Outfall ORIGINAL BID/RFP NUMBER & NAME: U8413, Geotechnical Testing Services On- Call MASTER AGREEMENT EFFECTIVE DATE: UJanuary 1, 2017 ARCHITECT/ENGINEER: UAnderson Consulting OWNER’S REPRESENTATIVE: UHeather McDowell WORK ORDER COMMENCEMENT DATE: UDecember 31, 2020 WORK ORDER COMPLETION DATE: UJune 30, 2020 MAXIMUM FEE: (time and reimbursable direct costs): U$12,900.00 PROJECT DESCRIPTION/SCOPE OF SERVICES: USoils and material testing for Remington Stormwater Outfall. 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: 63DDFEE7-46E8-468E-8488-8D8491CB8CA5 December 19, 2019 Heather Grubb Field Department Manager 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 REQUISITION ENTERED BY: Date: 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: 63DDFEE7-46E8-468E-8488-8D8491CB8CA5 12/19/19 Melissa Walker Coordinator, Finance December 20, 2019 December 19, 2019 December 20, 2019 December 20, 2019 December 20, 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: 63DDFEE7-46E8-468E-8488-8D8491CB8CA5 400 North Link Lane | Fort Collins, Colorado 80524 Telephone: 970-206-9455 Fax: 970-206-9441 December 4, 2019 City of Fort Collins Water Engineering 700 Wood Street Fort Collins, Colorado 80521 Attention: Heather McDowell, P.E. Subject: Fee Estimate for Construction Observation and Materials Testing Services Remington Street Storm Sewer Outfall Project Fort Collins, Colorado Fee Estimate No. FC 19-0420 At your request, CTL|Thompson, Inc. is pleased to provide this fee estimate for Construction Observation and Materials Testing services for the Remington Street Storm Sewer Outfall project located in Fort Collins, Colorado. We used the soils reports 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. We further understand that testing is to be completed on an as-needed basis during construction between February 17 and June 30, 2020. Soil Compaction Testing: Compaction testing for storm trench backfill, sanitary trench backfill, waterline trench backfill and aggregate base course will be necessary. We estimate 42 site visits will be necessary. Soil Compaction Testing 42 days x 2 hrs/day x $70/hr $5,880.00 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: $6,540.00 Asphalt Testing: Asphalt testing will be necessary. We estimate 6 days of paving will be necessary. AC/Gradation Test 6 tests x $170/test $1,020.00 Max Theoretical Density Test 6 tests x $90/test $540.00 Asphalt Testing 6 days x 5 hrs/day x $70/hr $2,100.00 Subtotal: $3,660.00 Page 4 of 6 DocuSign Envelope ID: 63DDFEE7-46E8-468E-8488-8D8491CB8CA5 CITY OF FORT COLLINS REMINGTON STREET STORM SEWER OUTFALL CTL | T FEE ESTIMATE NO. FC-19-0420 2 Concrete Testing: Concrete testing may be required for the crosspan, inlets, sidewalk and curb replacement. We estimate 15 tests will be required. Concrete Tests 15 tests x $180/test $2,700.00 Subtotal: $2,700.00 TOTAL ESTIMATED FEE: $12,900.00 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: 63DDFEE7-46E8-468E-8488-8D8491CB8CA5 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: 63DDFEE7-46E8-468E-8488-8D8491CB8CA5 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. Additional Insured: City of Fort Collins. 2 of 2 #S26675115/M26670904 DocuSign Envelope ID: 63DDFEE7-46E8-468E-8488-8D8491CB8CA5 Certificate Of Completion Envelope Id: 63DDFEE746E8468E84888D8491CB8CA5 Status: Completed Subject: Please DocuSign: CTL Thompson - Remington Stormwater Outfall Work Order.pdf Source Envelope: Document Pages: 8 Signatures: 7 Envelope Originator: Certificate Pages: 5 Initials: 0 Angel Anderson AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-08:00) Pacific Time (US & Canada) 215 N Mason Street Fort Collins, CO 80522 aanderson@fcgov.com IP Address: 198.59.47.100 Record Tracking Status: Original 12/17/2019 7:34:06 AM Holder: Angel Anderson aanderson@fcgov.com Location: DocuSign Signer Events Signature Timestamp Melissa Walker mjwalker@fcgov.com Coordinator, Finance City of Fort Collins – Utilities Financial Operations Security Level: Email, Account Authentication (None) Signature Adoption: Drawn on Device Using IP Address: 198.59.47.100 Sent: 12/17/2019 7:38:15 AM Viewed: 12/19/2019 11:31:42 AM Signed: 12/19/2019 11:31:52 AM Electronic Record and Signature Disclosure: Accepted: 12/20/2016 10:08:43 AM ID: d9d08390-1c30-4e0f-8970-cda5245e1382 Elliot Dale edale@fcgov.com Buyer City of Fort Collins Security Level: Email, Account Authentication (None) Signature Adoption: Uploaded Signature Image Using IP Address: 198.59.47.100 Sent: 12/19/2019 11:31:54 AM Viewed: 12/20/2019 7:00:30 AM Signed: 12/20/2019 8:08:41 AM Electronic Record and Signature Disclosure: Accepted: 7/17/2017 10:10:53 AM ID: ec325db7-18a4-43ec-adda-55edfc66426b Heather Grubb hgrubb@ctlthompson.com Field Department Manager CTL Thompson, Inc. Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 50.209.254.194 Sent: 12/19/2019 11:31:54 AM Viewed: 12/19/2019 1:17:35 PM Signed: 12/19/2019 1:37:13 PM Electronic Record and Signature Disclosure: Signer Events Signature Timestamp Andrew S. Gingerich AGingerich@fcgov.com Director, Water Field Operations City of Fort Collins Utilities Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 198.59.47.100 Signed using mobile Sent: 12/20/2019 8:08:43 AM Viewed: 12/20/2019 8:35:09 AM Signed: 12/20/2019 8:35:14 AM Electronic Record and Signature Disclosure: Accepted: 9/23/2016 12:43:26 PM ID: 54958527-6090-40dd-bdca-d96cb40048ed Matt Fater MFATER@fcgov.com Special Projects Manager City of Fort Collins Utilities Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 198.59.47.100 Sent: 12/20/2019 8:08:43 AM Viewed: 12/20/2019 8:16:15 AM Signed: 12/20/2019 8:17:25 AM Electronic Record and Signature Disclosure: Accepted: 12/6/2016 4:18:20 PM ID: 1a8e8b4d-d117-4be0-975e-cb548f822347 Theresa Connor tconnor@fcgov.com Water Engineering & Field Services Operations Manager City of Fort Collins Utilities Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 198.59.47.100 Sent: 12/20/2019 8:35:16 AM Viewed: 12/20/2019 9:48:18 AM Signed: 12/20/2019 9:48:28 AM Electronic Record and Signature Disclosure: Not Offered via DocuSign In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 12/20/2019 8:35:16 AM Certified Delivered Security Checked 12/20/2019 9:48:18 AM Signing Complete Security Checked 12/20/2019 9:48:28 AM Completed Security Checked 12/20/2019 9:48:28 AM Payment Events Status Timestamps Electronic Record and Signature Disclosure ELECTRONIC RECORD AND SIGNATURE DISCLOSURE From time to time, City of Fort Collins - Utilities Water Engineering Field Operations (we, us or Company) may be required by law to provide to you certain written notices or disclosures. 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Accepted: 5/1/2018 9:30:28 AM ID: bb111c3e-49e1-4439-80a1-b239fc29ac6f Heather McDowell hmcdowell@fcgov.com Civil Engineer III City of Fort Collins - Utilities Water Engineering Field Operations Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 198.59.47.100 Sent: 12/19/2019 11:31:54 AM Viewed: 12/19/2019 11:57:36 AM Signed: 12/19/2019 11:57:44 AM Electronic Record and Signature Disclosure: Not Offered via DocuSign 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 Pinnacol Assurance Company Starr Surplus Lines Insurance Company Charter Oak Fire Insurance Company 9/26/2019 USI Insurance Services, LLC P.O. Box 7050 Englewood, CO 80155 800 873-8500 800 873-8500 CTL / Thompson, Inc. 7306 S. Alton Way Centennial, CO 80112 25674 41190 13604 25615 A X X X X X 6806H199682 10/01/2019 10/01/2020 1,000,000 1,000,000 10,000 1,000,000 2,000,000 2,000,000 D X X X X X 8101175R522 10/01/2019 10/01/2020 1,000,000 A X X X 10000 X X CUP3C002974 10/01/2019 10/01/2020 8,000,000 8,000,000 B N X 180512 10/01/2019 10/01/2020 X 500,000 500,000 500,000 C Professional Liab Incl. Pollution Claims Made SLSLPRO26233619 10/01/2019 10/01/2020 $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) City of Fort Collins PO Box 580 Fort Collins, CO 80522 1 of 2 #S26675115/M26670904 Client#: 1082473 CTLTHO P1DZP 1 of 2 #S26675115/M26670904 DocuSign Envelope ID: 63DDFEE7-46E8-468E-8488-8D8491CB8CA5