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HomeMy WebLinkAboutCORRESPONDENCE - RFP - 9071 CONSTRUCTION SERVICES FOR HALLIGAN WATER SUPPLY PROJECT (2)WORK ORDER PURSUANT TO A MASTER AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND DRAGADOS-PULICE JOINT VENTURE WORK ORDER NUMBER: D-HWSP-2020-12 PROJECT TITLE: Halligan Project 02 - Drilling, Site Planning, Alternatives ORIGINAL BID/RFP NUMBER & NAME: 9071, Halligan Water Supply Project MASTER AGREEMENT EFFECTIVE DATE: June 22, 2020 ARCHITECT/ENGINEER: NA OWNER’S REPRESENTATIVE: Linsey Chalfant WORK ORDER COMMENCEMENT DATE: September 14, 2020 WORK ORDER COMPLETION DATE: May 31, 2021 MAXIMUM FEE: (time and reimbursable direct costs): $199,533.90 PROJECT DESCRIPTION/SCOPE OF SERVICES: Scope of work for work order 02 includes drilling, site planning, and alternatives. 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 eleven (11) 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: Dragados-Pulice Joint Venture By: Date: Name: Title: Page 1 of 17 DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 September 24, 2020 Ramon Fiuza Executive VP Steve Campbell September 22, 2020 CMGC Advisor OWNER’S ACCEPTANCE & EXECUTION: This Work Order and the attached Contract Documents are hereby accepted and incorporated herein by this reference. ACCEPTANCE: Date: Linsey Chalfant, Civil Engineer III REVIEWED: Date: Pat Johnson, Senior Buyer REQUISITION ENTERED BY: Date: Melissa Walker, Coordinator, Finance ACCEPTANCE: Date: Matt Fater, Director, Civil Engineering ACCEPTANCE: Date: Eileen Dornfest, Halligan Project Manager ACCEPTANCE: Date: Theresa Connor, Interim Utilities Executive Director 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 17 DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 9/17/20 September 22, 2020 September 22, 2020 September 25, 2020 September 25, 2020 September 25, 2020 September 25, 2020 ATTACHMENT A WORK ORDER COST OF SERVICES Page 3 of 17 DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 555 Anton Blvd. Suite 1000 | Costa Mesa, CA. 92626 | Phone: (949) 490-1800 September 3, 2020 City of Fort Collins Water Engineering Capital Projects 700 Wood Street Fort Collins, CO 80522 Attention: Linsey R. Chalfant Subject: Work Order #2 Dear Linsey, Dragados-Pulice Joint Venture has reviewed the scope of work for Work Order #2 Drilling, Site Planning, Design Alternatives and proposes an allowance of $199,533.90; see Attachment 1. A high level schedule for this work order tasks is included as Attachment 2. If you have questions, please contact us. Sincerely, Dragados-Pulice Joint Venture Manuel Morejon Project Manager Attachments: (1) Green Sheets (2) Schedule Page 4 of 17 DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 PROJECT: Proposal Date: Code: 9071 PWO: 2 WO #: 2 Pay Est.: Description: Qty: Unit: Unit Price: Total $: Item 1: $ - $ 50,740.00 Item 2: $ - $ 6,000.00 Item 3: $ - $ 54,090.00 Item 4: $ - $ 47,360.00 Item 5: $ - $ 5,160.00 Item 6: $ - $ 28,290.00 Item 7: $ - $ 7,893.90 Item 8: $ - $ - Item 9: $ - $ - Item 10: $ - $ - Item 11: $ - $ - Item 12: $ - $ - Item 13: $ - $ - Item 14: $ - $ - Item 15: $ - $ - Item 16: $ - $ - Item 17: $ - $ - Item 18: $ - $ - Item 19: $ - $ - Item 20: $ - $ - Total: Drilling, Site Planning, Design Alternatives $ 199,533.90 Other Coordination Risk Register Design alternatives, quarry sites, spillway evaluation JV Office Reimbursable Expenses Halligan Water Supply Project COST BREAKDOWN Site Investigation Fall 2020 Weekly 1 hour Meetings Site Planning 8/19/2020 Overall Description: Drilling, Site Planning, Design Alternatives Page 5 of 17 Revised: 8/19/20 DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 PROJECT: Proposal Date: Code: 9071 PWO: 2 WO #: 2 Pay Est.: STAFF HOURS REG OT CODE TITLE NAME HOURS RATE HOURS RATE TOTAL ST01 Project Manager Manuel Morejon 275 250 250 $ 68,750.00 ST02 Senior Technical Advisor Rafael Ibáñez 165 230 230 $ 37,950.00 ST03 Dam Construction Expert Dwain Sanders 86 220 220 $ 18,920.00 ST05 Senior Project Engineer Stanley Ellis, PE 102 165 165 $ 16,830.00 ST08 Environmental Manager Jason Phillips 46 175 175 $ 8,050.00 ST09 Estimating and Scheduling Manager Chris Peich 73 230 230 $ 16,790.00 ST13 Field Engineer Andrea Lau 122 75 75 $ 9,150.00 STAFF TOTAL HOURS 869 0 STAFF SUBTOTAL $ 176,440.00 REIMBURSABLE EXPENSES TYPE UNIT RATE Allowance ALL ####### $ 8,000.00 Allowance ALL $ 500.00 $ 2,000.00 Allowance ALL ####### $ 4,000.00 Allowance ALL $ 300.00 $ 1,200.00 Allowance ALL ####### $ 5,076.40 Allowance ALL $ 600.00 $ 840.00 Allowance ALL ####### $ 1,977.50 REIMBURSABLE EXPENSES SUBTOTAL $ 23,093.90 LABOR REG REG OT DT OT DT Craft DESCRIPTION HOURS RATE RATE RATE TOTAL LABOR SUBTOTAL $ - 0% LABOR SURCHARGE $ - LABOR TOTAL $ - SUBCONTRACTOR UNIT RATE $ - SUBCONTRACTOR SUBTOTAL $ - EQUIPMENT REG OT HOURS RATE RATE TOTAL EQUIPMENT SUBTOTAL $ - HAUL UNIT RATE $ - TRUCKING SUBTOTAL $ - MATERIALS OR SUPPLIERS UNIT RATE $ - $ - $ - OUTSIDE MATERIALS SUBTOTAL $ - NOTES: 17% LABOR MARKUP $ - 17% EQUIPMENT & MATERIALS MARKUP $ - 17% SUBCONTRACT MARKUP $ - 3% BOND AND INSURANCE MARKUP $ - TOTAL WORK $ 199,533.90 UNIT PRICE WORK $ - Drilling, Site Planning, Design Alternatives Halligan Water Supply Project COST BREAKDOWN 8/19/2020 PROJECT: Proposal Date: Work Date: Code: 9071 PWO: 2 WO #: 2 Pay Est.: PRODUCTION UNITS : UOM: STAFF REG OT CODE TITLE NAME HOURS RATE RATE TOTAL ST01 Project Manager Manuel Morejon 94 250 250 $ 23,500.00 ST02 Senior Technical Advisor Rafael Ibáñez 48 230 230 $ 11,040.00 ST03 Dam Construction Expert Dwain Sanders 22 220 220 $ 4,840.00 ST05 Senior Project Engineer Stanley Ellis, PE 24 165 165 $ 3,960.00 ST13 Field Engineer Andrea Lau 48 75 75 $ 3,600.00 STAFF SUBTOTAL $ 46,940.00 REIMBURSABLE EXPENSES TYPE UNIT RATE Allowance ALL $ 2,000.00 $ 2,000.00 Allowance ALL $ 500.00 $ 500.00 Allowance ALL $ 1,000.00 $ 1,000.00 Allowance ALL $ 300.00 $ 300.00 REIMBURSABLE EXPENSES SUBTOTAL $ 3,800.00 LABOR REG REG OT DT OT DT Craft DESCRIPTION HOURS RATE RATE RATE TOTAL LABOR SUBTOTAL $ - 0% LABOR SURCHARGE $ - LABOR TOTAL $ - SUBCONTRACTOR UNIT RATE $ - SUBCONTRACTOR SUBTOTAL $ - EQUIPMENT REG OT HOURS RATE RATE TOTAL EQUIPMENT SUBTOTAL $ - HAUL UNIT RATE $ - TRUCKING SUBTOTAL $ - MATERIALS OR SUPPLIERS UNIT RATE $ - $ - $ - OUTSIDE MATERIALS SUBTOTAL $ - NOTES: 17% LABOR MARKUP $ - 17% EQUIPMENT & MATERIALS MARKUP $ - 17% SUBCONTRACT MARKUP $ - 3% BOND AND INSURANCE MARKUP $ - TOTAL WORK $ 50,740.00 UNIT PRICE WORK $ - PROJECT: Proposal Date: Work Date: Code: 9071 PWO: 2 WO #: 2 Pay Est.: PRODUCTION UNITS : UOM: STAFF REG OT CODE TITLE NAME HOURS RATE RATE TOTAL ST01 Project Manager Manuel Morejon 24 250 250 $ 6,000.00 STAFF SUBTOTAL $ 6,000.00 REIMBURSABLE EXPENSES TYPE UNIT RATE REIMBURSABLE EXPENSES SUBTOTAL $ - LABOR REG REG OT DT OT DT Craft DESCRIPTION HOURS RATE RATE RATE TOTAL LABOR SUBTOTAL $ - 0% LABOR SURCHARGE $ - LABOR TOTAL $ - SUBCONTRACTOR UNIT RATE $ - SUBCONTRACTOR SUBTOTAL $ - EQUIPMENT REG OT HOURS RATE RATE TOTAL EQUIPMENT SUBTOTAL $ - HAUL UNIT RATE $ - TRUCKING SUBTOTAL $ - MATERIALS OR SUPPLIERS UNIT RATE $ - $ - $ - OUTSIDE MATERIALS SUBTOTAL $ - NOTES: 17% LABOR MARKUP $ - 17% EQUIPMENT & MATERIALS MARKUP $ - 17% SUBCONTRACT MARKUP $ - 3% BOND AND INSURANCE MARKUP $ - TOTAL WORK $ 6,000.00 UNIT PRICE WORK $ - QTY Halligan Water Supply Project COST BREAKDOWN HOURS 8/19/2020 Item 2 Description: Weekly 1 hour Meetings OT DESCRIPTION QTY DESCRIPTION QTY OT DESCRIPTION HOURS HOURS DESCRIPTION QTY 1. Sep, Oct, Nov and Dec: 16 weeks. Via Teleconference. PROJECT: Proposal Date: Work Date: Code: 9071 PWO: 2 WO #: 2 Pay Est.: PRODUCTION UNITS : UOM: STAFF REG OT CODE TITLE NAME HOURS RATE RATE TOTAL ST01 Project Manager Manuel Morejon 62 250 250 $ 15,500.00 ST02 Senior Technical Advisor Rafael Ibáñez 36 230 230 $ 8,280.00 ST03 Dam Construction Expert Dwain Sanders 20 220 220 $ 4,400.00 ST05 Senior Project Engineer Stanley Ellis, PE 12 165 165 $ 1,980.00 ST08 Environmental Manager Jason Phillips 46 175 175 $ 8,050.00 ST09 Estimating and Scheduling Manager Chris Peich 46 230 230 $ 10,580.00 ST13 Field Engineer Andrea Lau 20 75 75 $ 1,500.00 STAFF SUBTOTAL $ 50,290.00 REIMBURSABLE EXPENSES TYPE UNIT RATE Allowance ALL $ 2,000.00 $ 2,000.00 Allowance ALL $ 500.00 $ 500.00 Allowance ALL $ 1,000.00 $ 1,000.00 Allowance ALL $ 300.00 $ 300.00 REIMBURSABLE EXPENSES SUBTOTAL $ 3,800.00 LABOR REG REG OT DT OT DT Craft DESCRIPTION HOURS RATE RATE RATE TOTAL LABOR SUBTOTAL $ - 0% LABOR SURCHARGE $ - LABOR TOTAL $ - SUBCONTRACTOR UNIT RATE $ - SUBCONTRACTOR SUBTOTAL $ - EQUIPMENT REG OT HOURS RATE RATE TOTAL EQUIPMENT SUBTOTAL $ - HAUL UNIT RATE $ - TRUCKING SUBTOTAL $ - MATERIALS OR SUPPLIERS UNIT RATE $ - $ - $ - OUTSIDE MATERIALS SUBTOTAL $ - PROJECT: Proposal Date: Work Date: Code: 9071 PWO: 2 WO #: 2 Pay Est.: PRODUCTION UNITS : UOM: STAFF REG OT CODE TITLE NAME HOURS RATE RATE TOTAL ST01 Project Manager Manuel Morejon 35 250 250 $ 8,750.00 ST02 Senior Technical Advisor Rafael Ibáñez 51 230 230 $ 11,730.00 ST03 Dam Construction ExpertDwain Sanders 34 220 220 $ 7,480.00 ST05 Senior Project Engineer Stanley Ellis, PE 46 165 165 $ 7,590.00 ST09 Estimating and Scheduling Chris Manager Peich 27 230 230 $ 6,210.00 ST13 Field Engineer Andrea Lau 24 75 75 $ 1,800.00 STAFF SUBTOTAL $ 43,560.00 REIMBURSABLE EXPENSES TYPE UNIT RATE Allowance ALL $ 2,000.00 $ 2,000.00 Allowance ALL $ 500.00 $ 500.00 Allowance ALL $ 1,000.00 $ 1,000.00 Allowance ALL $ 300.00 $ 300.00 REIMBURSABLE EXPENSES SUBTOTAL $ 3,800.00 LABOR REG REG OT DT OT DT Craft DESCRIPTION HOURS RATE RATE RATE TOTAL LABOR SUBTOTAL $ - 0% LABOR SURCHARGE $ - LABOR TOTAL $ - SUBCONTRACTOR UNIT RATE $ - SUBCONTRACTOR SUBTOTAL $ - EQUIPMENT REG OT HOURS RATE RATE TOTAL EQUIPMENT SUBTOTAL $ - HAUL UNIT RATE $ - TRUCKING SUBTOTAL $ - MATERIALS OR SUPPLIERS UNIT RATE $ - $ - $ - OUTSIDE MATERIALS SUBTOTAL $ - NOTES: 17% LABOR MARKUP $ - 17% EQUIPMENT & MATERIALS MARKUP $ - 17% SUBCONTRACT MARKUP $ - 3% BOND AND INSURANCE MARKUP $ - TOTAL WORK $ 47,360.00 UNIT PRICE WORK $ - QTY Halligan Water Supply Project COST BREAKDOWN HOURS 8/19/2020 Item 4 Description: PROJECT: Proposal Date: Work Date: Code: 9071 PWO: 2 WO #: 2 Pay Est.: PRODUCTION UNITS : UOM: STAFF REG OT CODE TITLE NAME HOURS RATE RATE TOTAL ST01 Project Manager Manuel Morejon 8 250 250 $ 2,000.00 ST02 Senior Technical Advisor Rafael Ibáñez 8 230 230 $ 1,840.00 ST05 Senior Project Engineer Stanley Ellis, PE 8 165 165 $ 1,320.00 STAFF SUBTOTAL $ 5,160.00 REIMBURSABLE EXPENSES TYPE UNIT RATE REIMBURSABLE EXPENSES SUBTOTAL $ - LABOR REG REG OT DT OT DT Craft DESCRIPTION HOURS RATE RATE RATE TOTAL LABOR SUBTOTAL $ - 0% LABOR SURCHARGE $ - LABOR TOTAL $ - SUBCONTRACTOR UNIT RATE $ - SUBCONTRACTOR SUBTOTAL $ - EQUIPMENT REG OT HOURS RATE RATE TOTAL EQUIPMENT SUBTOTAL $ - HAUL UNIT RATE $ - TRUCKING SUBTOTAL $ - MATERIALS OR SUPPLIERS UNIT RATE $ - $ - $ - OUTSIDE MATERIALS SUBTOTAL $ - NOTES: 17% LABOR MARKUP $ - 17% EQUIPMENT & MATERIALS MARKUP $ - 17% SUBCONTRACT MARKUP $ - 3% BOND AND INSURANCE MARKUP $ - TOTAL WORK $ 5,160.00 UNIT PRICE WORK $ - QTY Halligan Water Supply Project COST BREAKDOWN HOURS 8/19/2020 Item 5 Description: Risk Register OT DESCRIPTION QTY HOURS PROJECT: Proposal Date: Work Date: Code: 9071 PWO: 2 WO #: 2 Pay Est.: PRODUCTION UNITS : UOM: STAFF REG OT CODE TITLE NAME HOURS RATE RATE TOTAL ST01 Project Manager Manuel Morejon 52 250 250 $ 13,000.00 ST02 Senior Technical Advisor Rafael Ibáñez 22 230 230 $ 5,060.00 ST03 Dam Construction ExpertDwain Sanders 10 220 220 $ 2,200.00 ST05 Senior Project Engineer Stanley Ellis, PE 12 165 165 $ 1,980.00 ST13 Field Engineer Andrea Lau 30 75 75 $ 2,250.00 STAFF SUBTOTAL $ 24,490.00 REIMBURSABLE EXPENSES TYPE UNIT RATE Allowance ALL $ 2,000.00 $ 2,000.00 Allowance ALL $ 500.00 $ 500.00 Allowance ALL $ 1,000.00 $ 1,000.00 Allowance ALL $ 300.00 $ 300.00 REIMBURSABLE EXPENSES SUBTOTAL $ 3,800.00 LABOR REG REG OT DT OT DT Craft DESCRIPTION HOURS RATE RATE RATE TOTAL LABOR SUBTOTAL $ - 0% LABOR SURCHARGE $ - LABOR TOTAL $ - SUBCONTRACTOR UNIT RATE $ - SUBCONTRACTOR SUBTOTAL $ - EQUIPMENT REG OT HOURS RATE RATE TOTAL EQUIPMENT SUBTOTAL $ - HAUL UNIT RATE $ - TRUCKING SUBTOTAL $ - MATERIALS OR SUPPLIERS UNIT RATE $ - $ - $ - OUTSIDE MATERIALS SUBTOTAL $ - NOTES: 17% LABOR MARKUP $ - 17% EQUIPMENT & MATERIALS MARKUP $ - 17% SUBCONTRACT MARKUP $ - 3% BOND AND INSURANCE MARKUP $ - TOTAL WORK $ 28,290.00 UNIT PRICE WORK $ - QTY Halligan Water Supply Project COST BREAKDOWN HOURS 8/19/2020 Item 6 Description: Other Coordination PROJECT: Proposal Date: Work Date: Code: 9071 PWO: 2 WO #: 2 Pay Est.: PRODUCTION UNITS : UOM: STAFF REG OT CODE TITLE NAME HOURS RATE RATE TOTAL STAFF SUBTOTAL $ - REIMBURSABLE EXPENSES TYPE UNIT RATE Allowance Month $ 3,626.00 $ 5,076.40 Allowance Month $ 600.00 $ 840.00 Allowance Month $ 1,412.50 $ 1,977.50 REIMBURSABLE EXPENSES SUBTOTAL $ 7,893.90 LABOR REG REG OT DT OT DT Craft DESCRIPTION HOURS RATE RATE RATE TOTAL LABOR SUBTOTAL $ - 0% LABOR SURCHARGE $ - LABOR TOTAL $ - SUBCONTRACTOR UNIT RATE $ - SUBCONTRACTOR SUBTOTAL $ - EQUIPMENT REG OT HOURS RATE RATE TOTAL EQUIPMENT SUBTOTAL $ - HAUL UNIT RATE $ - TRUCKING SUBTOTAL $ - MATERIALS OR SUPPLIERS UNIT RATE $ - $ - $ - OUTSIDE MATERIALS SUBTOTAL $ - NOTES: 17% LABOR MARKUP $ - 17% EQUIPMENT & MATERIALS MARKUP $ - 17% SUBCONTRACT MARKUP $ - 3% BOND AND INSURANCE MARKUP $ - TOTAL WORK $ 7,893.90 UNIT PRICE WORK $ - Halligan Water Supply Project COST BREAKDOWN HOURS 8/19/2020 Item 7 Description: OT JV Office Reimbursable Expenses HOURS DESCRIPTION QTY DESCRIPTION QTY DESCRIPTION QTY DESCRIPTION OT ID WBS Name Duration Start Finish Predecessors 0 0 HALLIGAN WATER SUPPLY PROJECT 120 days Mon 9/14/20 Fri 2/26/21 1 1 WORK ORDER #2 Drilling, Site Planning, Design Alternatives 120 days Mon 9/14/20 Fri 2/26/21 2 1.1 Site Investigations Fall 2020 35 days Mon 9/14/20 Fri 10/30/20 3 1.1.1 Site Development 35 days Mon 9/14/20 Fri 10/30/20 4 1.1.2 Rock Coring 15 days Mon 9/28/20 Fri 10/16/20 5 1.1.3 Geophysics 5 days Mon 9/21/20 Fri 9/25/20 6 1.1.4 Dam Coring 7 days Mon 10/5/20 Tue 10/13/20 7 1.2 Weekly 1 hour Meetings 120 days Mon 9/14/20 Fri 2/26/21 8 1.3 Site Planning 50 days Mon 10/5/20 Fri 12/11/20 9 1.3.1 Fish and Wildlife Cost Estimates 40 days Mon 10/5/20 Fri 11/27/20 10 1.3.2 Recreational Areas Evaluation 40 days Mon 10/5/20 Fri 11/27/20 11 1.3.3 Halligan Reservoir Sediment 30 days Mon 10/5/20 Fri 11/13/20 12 1.3.4 Operations and Maintenance 20 days Mon 11/2/20 Fri 11/27/20 13 1.3.5 Access Roads / Staging Impacts During Construction 40 days Mon 10/19/20 Fri 12/11/20 14 1.3.6 D/S River Crossing 30 days Mon 10/12/20 Fri 11/20/20 15 1.4 Design Alternatives, quarry sites, spillway evaluation 56 days Mon 11/30/20 Mon 2/15/21 16 1.4.1 Dam Selection Alternatives 50 days Mon 11/30/20 Fri 2/5/21 17 1.4.2 Quarry Sites 30 days Mon 11/30/20 Fri 1/8/21 18 1.4.3 Spillway Evaluation 40 days Mon 11/30/20 Fri 1/22/21 19 1.4.4 Alternatives Workshop 1 1 day Tue 12/15/20 Tue 12/15/20 20 1.4.5 Alternatives Workshop 2 1 day Mon 2/15/21 Mon 2/15/21 21 1.5 Risk Register 56 days Mon 11/2/20 Mon 1/18/21 22 1.5.1 Risk Register Workshop 1 1 day Mon 11/2/20 Mon 11/2/20 23 1.5.2 Risk Register Workshop 2 1 day Mon 1/18/21 Mon 1/18/21 24 1.6 Other Coordination 120 days Mon 9/14/20 Fri 2/26/21 25 1.7 JV Office Reimbursable Expenses 120 days Mon 9/14/20 Fri 2/26/21 7 14 21 28 5 12 19 26 2 9 16 23 30 7 14 21 28 4 11 18 25 1 8 15 22 1 September October November December January February 9071 Contractor Services for Halligan Water Supply Project DATE: 09-02-2020. SCHEDULE 1 / 1 Page 14 of 17 DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 ATTACHMENT B WORK ORDER SCHEDULE OF SERVICES Page 15 of 17 DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 ID WBS Name Duration Start Finish Predecessors 0 0 HALLIGAN WATER SUPPLY PROJECT 120 days Mon 9/14/20 Fri 2/26/21 1 1 WORK ORDER #2 Drilling, Site Planning, Design Alternatives 120 days Mon 9/14/20 Fri 2/26/21 2 1.1 Site Investigations Fall 2020 35 days Mon 9/14/20 Fri 10/30/20 3 1.1.1 Site Development 35 days Mon 9/14/20 Fri 10/30/20 4 1.1.2 Rock Coring 15 days Mon 9/28/20 Fri 10/16/20 5 1.1.3 Geophysics 5 days Mon 9/21/20 Fri 9/25/20 6 1.1.4 Dam Coring 7 days Mon 10/5/20 Tue 10/13/20 7 1.2 Weekly 1 hour Meetings 120 days Mon 9/14/20 Fri 2/26/21 8 1.3 Site Planning 50 days Mon 10/5/20 Fri 12/11/20 9 1.3.1 Fish and Wildlife Cost Estimates 40 days Mon 10/5/20 Fri 11/27/20 10 1.3.2 Recreational Areas Evaluation 40 days Mon 10/5/20 Fri 11/27/20 11 1.3.3 Halligan Reservoir Sediment 30 days Mon 10/5/20 Fri 11/13/20 12 1.3.4 Operations and Maintenance 20 days Mon 11/2/20 Fri 11/27/20 13 1.3.5 Access Roads / Staging Impacts During Construction 40 days Mon 10/19/20 Fri 12/11/20 14 1.3.6 D/S River Crossing 30 days Mon 10/12/20 Fri 11/20/20 15 1.4 Design Alternatives, quarry sites, spillway evaluation 56 days Mon 11/30/20 Mon 2/15/21 16 1.4.1 Dam Selection Alternatives 50 days Mon 11/30/20 Fri 2/5/21 17 1.4.2 Quarry Sites 30 days Mon 11/30/20 Fri 1/8/21 18 1.4.3 Spillway Evaluation 40 days Mon 11/30/20 Fri 1/22/21 19 1.4.4 Alternatives Workshop 1 1 day Tue 12/15/20 Tue 12/15/20 20 1.4.5 Alternatives Workshop 2 1 day Mon 2/15/21 Mon 2/15/21 21 1.5 Risk Register 56 days Mon 11/2/20 Mon 1/18/21 22 1.5.1 Risk Register Workshop 1 1 day Mon 11/2/20 Mon 11/2/20 23 1.5.2 Risk Register Workshop 2 1 day Mon 1/18/21 Mon 1/18/21 24 1.6 Other Coordination 120 days Mon 9/14/20 Fri 2/26/21 25 1.7 JV Office Reimbursable Expenses 120 days Mon 9/14/20 Fri 2/26/21 7 14 21 28 5 12 19 26 2 9 16 23 30 7 14 21 28 4 11 18 25 1 8 15 22 1 September October November December January February 9071 Contractor Services for Halligan Water Supply Project DATE: 09-02-2020. SCHEDULE 1 / 1 Page 16 of 17 DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 ATTACHMENT C CERTIFICATE OF INSURANCE CONTRACTOR shall submit Certificate of Insurance in compliance with the Contract Documents. All Halligan Contractors - Please list the following landowners as additionally Insured. • The Landowners’ Association for Phantom Canyon Ranches • Calloway Hill Preserve, LLC • Geo. A. Henderson Co., Inc., and Chris Vandemoer • James R. and Nancy E. Carpenter • The Nature Conservancy • North Poudre Irrigation Company Page 17 of 17 DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 Holder Identifier : 7777777707070700077763616065553330742516667305577407762315770625032071741557376120100777070423275733107237150310071200077404113126347500772621337443657407362031772036710077727252025773110777777707000707007 6666666606060600062606466204446200600222424006222206000226260060222060020262620402200600002626024222206022206062262000062002042622402200622200424204000206020026260002400066646062240664440666666606000606006 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/09/2020 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. PRODUCER Aon Risk Services Northeast, Inc. New York NY Office One Liberty Plaza 165 Broadway, Suite 3201 New York NY 10006 USA PHONE (A/C. No. Ext): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # (212) 441-1000 INSURED INSURER A: Liberty Insurance Corporation 42404 INSURER B: XL Insurance America Inc 24554 INSURER C: INSURER D: INSURER E: INSURER F: FAX (A/C. No.): CONTACT NAME: Dragados-Pulice Joint Venture 555 Anton Blvd, Suite 1000 Costa Mesa CA 92626 USA COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. Limits shown are as requested POLICY EXP (MM/DD/YYYY) POLICY EFF (MM/DD/YYYY) SUBR WVD INSR LTR ADDL TYPE OF INSURANCE INSD POLICY NUMBER LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR POLICY LOC EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY Excess Liability Program AGENCY CUSTOMER ID: ADDITIONAL REMARKS SCHEDULE LOC #: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance EFFECTIVE DATE: CARRIER NAIC CODE POLICY NUMBER AGENCY NAMED INSURED See Certificate Number: See Certificate Number: Aon Risk Services Northeast, Inc. 980000043978 Page _ of _ Dragados USA Inc XL Insurance America Inc Policy No.US00084611LI20A $5,000,000 each occurrence/aggregate excess of underlying General Liability, Auto Liability & Workers Compensation The Ohio Casualty Insurance Company Policy No. ECO2158726153 $15,000,000 each occurrence/aggregate excess of $5,000,000 Primary Excess ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 Certificate Of Completion Envelope Id: 149121ADF2B4486A8209B0B824C19039 Status: Completed Subject: Please DocuSign: Dragados-Pulice - Halligan Project 02 Drilling, Site Planning, Alternatives Wo... Source Envelope: Document Pages: 19 Signatures: 9 Envelope Originator: Certificate Pages: 6 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: 24.8.181.157 Record Tracking Status: Original 9/9/2020 7:08:01 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: 9/9/2020 7:11:49 AM Resent: 9/22/2020 10:19:12 AM Viewed: 9/22/2020 4:05:52 PM Signed: 9/22/2020 4:06:21 PM Electronic Record and Signature Disclosure: Accepted: 12/20/2016 10:08:43 AM ID: d9d08390-1c30-4e0f-8970-cda5245e1382 Pat Johnson pjohnson@fcgov.com CPPB, Senior Buyer City of Fort Collins Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 24.54.161.134 Sent: 9/9/2020 7:11:50 AM Resent: 9/22/2020 10:19:13 AM Viewed: 9/22/2020 3:11:28 PM Signed: 9/22/2020 3:17:22 PM Electronic Record and Signature Disclosure: Accepted: 3/6/2017 12:11:29 PM ID: 04e21175-6705-4189-8da6-00a1010bd0d2 Linsey Chalfant lchalfant@fcgov.com Special Projects Manager City of Fort Collins Utilities Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 174.198.166.30 Signed using mobile Sent: 9/22/2020 4:06:22 PM Signer Events Signature Timestamp Steve Campbell campbell@PULICE.com CMGC Advisor Security Level: Email, Account Authentication (None) Signature Adoption: Uploaded Signature Image Using IP Address: 72.214.209.205 Sent: 9/22/2020 4:06:22 PM Viewed: 9/22/2020 4:35:41 PM Signed: 9/22/2020 4:39:56 PM Electronic Record and Signature Disclosure: Accepted: 9/22/2020 4:35:41 PM ID: 4d4a489d-edc2-45a2-8fac-1a456ae8c57a Eileen Dornfest edornfest@fcgov.com Special Projects Manager City of Fort Collins Utilities Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 67.161.207.117 Signed using mobile Sent: 9/24/2020 5:42:53 PM Viewed: 9/25/2020 5:56:58 AM Signed: 9/25/2020 5:57:37 AM Electronic Record and Signature Disclosure: Accepted: 9/29/2017 7:50:54 AM ID: 2cb66c3f-651b-43ec-8309-8d841ea15c6c 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: 67.174.120.150 Sent: 9/24/2020 5:42:53 PM Resent: 9/25/2020 7:40:39 AM Viewed: 9/25/2020 7:40:42 AM Signed: 9/25/2020 7:45:18 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: 24.9.116.148 Sent: 9/25/2020 7:45:20 AM Viewed: 9/25/2020 8:07:39 AM Signed: 9/25/2020 8:08:19 AM Electronic Record and Signature Disclosure: Not Offered via DocuSign Gerry S. Paul gspaul@fcgov.com Purchasing Director Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Linsey Chalfant lchalfant@fcgov.com Special Projects Manager City of Fort Collins Utilities Security Level: Email, Account Authentication (None) Sent: 9/9/2020 7:11:49 AM Viewed: 9/9/2020 7:13:37 AM Electronic Record and Signature Disclosure: Accepted: 9/13/2017 2:26:04 PM ID: 3207f689-3f8e-4799-bc67-9f8766512080 Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 9/25/2020 8:08:21 AM Certified Delivered Security Checked 9/25/2020 8:54:45 AM Signing Complete Security Checked 9/25/2020 8:55:37 AM Completed Security Checked 9/25/2020 8:55:37 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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Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us. Electronic Record and Signature Disclosure created on: 8/25/2016 10:28:47 AM Parties agreed to: Melissa Walker, Pat Johnson, Linsey Chalfant, Ramon Fiuza, Steve Campbell, Eileen Dornfest, Matt Fater, Gerry S. 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City of Fort Collins Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 71.211.249.21 Sent: 9/25/2020 8:08:21 AM Viewed: 9/25/2020 8:54:45 AM Signed: 9/25/2020 8:55:37 AM Electronic Record and Signature Disclosure: Accepted: 3/7/2017 7:02:26 AM ID: 1dfa1693-39e5-474b-b394-82f385c8c8d4 In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Viewed: 9/22/2020 4:24:51 PM Signed: 9/22/2020 4:25:12 PM Electronic Record and Signature Disclosure: Accepted: 9/13/2017 2:26:04 PM ID: 3207f689-3f8e-4799-bc67-9f8766512080 Ramon Fiuza rfiuza@Dragados-USA.com Executive VP Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 4.16.196.186 Sent: 9/22/2020 4:06:22 PM Viewed: 9/24/2020 5:27:11 PM Signed: 9/24/2020 5:42:51 PM Electronic Record and Signature Disclosure: Accepted: 9/24/2020 5:27:11 PM ID: c7c2be0b-ecff-4d64-a274-c7c7e42ccfe1 GENERAL AGGREGATE PRODUCTS - COMP/OP AGG X X X X GEN'L AGGREGATE LIMIT APPLIES PER: $5,000,000 $1,000,000 $10,000 $5,000,000 $10,000,000 $10,000,000 A TB7611B6N3Q4030 06/01/2020 06/01/2021 PRO- JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON-OWNED AUTOS ONLY BODILY INJURY ( Per person) PROPERTY DAMAGE (Per accident) X X BODILY INJURY (Per accident) $2,000,000 A 06/01/2020 06/01/2021 Comp/Coll $5000 COMBINED SINGLE LIMIT (Ea accident) AS7-611-B6N3Q4-020 EXCESS LIAB X OCCUR CLAIMS-MADE AGGREGATE EACH OCCURRENCE DED $5,000,000 $5,000,000 UMBRELLA LIAB 06/01/2020 B US00084611LI20A 06/01/2021 RETENTION X E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT E.L. EACH ACCIDENT $1,000,000 X OTH- ER A 06/01/2020 06/01/2021 PER STATUTE $1,000,000 Y / N (Mandatory in NH) ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? N N / A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONS below $1,000,000 WC7611B6N3Q4010 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Halligan Water Supply Project - Work Order #2 - Drilling , Site Planning, Design Alternatives The Landowners’ Association for Phantom Canyon Ranches, Calloway Hill Preserve, LLC, Geo. A. Henderson Co., Inc., and Chris Vandemoer, James R. and Nancy E. Carpenter, City of Fort Collins, The Nature Conservancy and North Poudre Irrigation Company are included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies as required by written contract. City of Fort Collins is granted a Waiver of Subrogation as respects the General Liability, Auto Liability, Workers Compensation and Excess Liability in accordance with the policy provisions. CERTIFICATE HOLDER CANCELLATION CityREPRESENTATIVE of Fort Collins AUTHORIZED Attn: City's Purchasing Director P. O. Box 580 Fort Collins, Colorado 80522 USA ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 HOURS Fort Collins JV Office Rental (Apportioned) 1.4 Fort Collins JV Office Operations&Maintenance (Apportioned) 1.4 PM Company Vehicle 4x4 (Apportioned) 1.4 QTY 1. Estimated 35% of Level of Effort time for Project Manager relocated to Fort Collins. The % to be billed will be calculated monthly as: PM Hours / 160. 2. All reimbursable expenses will be justified with invoices actually paid. 3. 4. 5. 6. 7. 8. 9. Page 13 of 17 DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 OT DESCRIPTION QTY HOURS DESCRIPTION QTY DESCRIPTION QTY DESCRIPTION OT HOURS Reproduction Cost 1 Airfare 1 Car Rental and Fuel 1 Hotel/Lodging/Meals 1 1. Jobsite visits and offcie hours(permitting, landowners, etc.): PM (40 h), FE (30 h) 2. Estimated 1 jobsite visit of Senior Technical Adivsor and Dam Construction Expert: PM (10 h), STA (10 h), DCE (10 h) 3. Partnering (one every two months-virtually): PM (12 h), STA (12 h), SPE (12 h) 4. 5. 6. 7. Page 12 of 17 DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 DESCRIPTION QTY DESCRIPTION QTY DESCRIPTION OT HOURS 1. Risk Register Prep/Review: PM (4 h), STA (4 h), SPE (4 h) 2. Risk Register Workshop: PM (4 h), STA (4 h), SPE (4 h) 3. 4. 5. 6. 7. 8. 9. 10. Page 11 of 17 DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 Design alternatives, quarry sites, spillway evaluation OT DESCRIPTION QTY HOURS DESCRIPTION QTY DESCRIPTION QTY DESCRIPTION OT HOURS Reproduction Cost 1 Airfare 1 Car Rental and Fuel 1 Hotel/Lodging/Meals 1 1. Dam Selection Alternatives: PM (12 h), STA (12 h), SPE (12 h), DCE (8 h), ESM (8 h), FE (12 h) 2. Quarry Sites: PM (12 h), STA (12 h), SPE (8 h), DCE (8 h), ESM (8 h), FE (12 h) 3. Spillway Evaluation: PM (3 h), STA (3 h), SPE (2 h), DCE (2 h), ESM (3 h) 4. Alternatives Workshop (2 x 4 h): PM (8 h), STA (8 h), SPE (8 h), ESM (8) 5. Travel of 3 K-Staff for in person meeting in Fort Collins: STA (2 d x 8 h), DCE (2 d x 8 h), SPE (2 d x 8 h) 6. Page 10 of 17 DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 NOTES: 17% LABOR MARKUP $ - 17% EQUIPMENT & MATERIALS MARKUP $ - 17% SUBCONTRACT MARKUP $ - 3% BOND AND INSURANCE MARKUP $ - TOTAL WORK $ 54,090.00 UNIT PRICE WORK $ - QTY Halligan Water Supply Project COST BREAKDOWN HOURS 8/19/2020 Item 3 Description: Site Planning OT DESCRIPTION QTY HOURS DESCRIPTION QTY DESCRIPTION QTY DESCRIPTION OT HOURS Reproduction Cost 1 Airfare 1 Car Rental and Fuel 1 Hotel/Lodging/Meals 1 1. Fish and Wildlife Cost estimates Fish: PM (8 h), STA (4 h), EM (4 h), ESM (4 h) 2. Recreational Areas Evaluation: PM (6 h), EM (4 h) , ESM (4 h) 3. Halligan Reservoir Sediment: PM (6 h), STA (4 h), EM (2 h), DCE (4 h), FE (4 h) 4. Sediment During Construction: PM (6 h), STA (4 h), EM (4 h), DCE (4 h) 5. Operations and Maintenance: PM (12 h), SPE (8 h), FE (8 h) 6. Access Roads/Staging Impacts during construction: PM (12 h), STA (12 h), DCE (8 h), ESM (8 h), FE (8h) 7. D/S river crossing: PM (12 h), STA (12 h), SPE (4 h), DCE (4 h), ESM (6 h) 8. Environmental Manager Site Visit for all subjects: 4 d x 8 hours 9. Estimating and Scheduling Manager Site Visit for all subjects: 3 d x 8 hours Page 9 of 17 DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 2. 8 addtional hours for meetings preparation. 3. 4. 5. 6. Page 8 of 17 DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 QTY Airfare 1 Car Rental and Fuel 1 Hotel/Lodging/Meals OT HOURS QTY QTY DESCRIPTION DESCRIPTION QTY Halligan Water Supply Project COST BREAKDOWN 8/19/2020 Site Investigation Fall 2020 Item 1 Description: HOURS OT HOURS Reproduction Cost 1 DESCRIPTION DESCRIPTION 1 1. Site Development: Jobsite (PM: 4 d x 6 h, STA: 2 d x 8 h, DCE: 2 d x 8 h, FE: 2 d x 6 h), Office (PM: 4 h, STA: 4 h, DCE: 4 h) 2. Rock Coring: Jobsite (PM: 3 d x 6 h, , STA: 2 d x 8 h, FE: 2 d x 6 h), Office (PM:4 h, STA: 4 h, SPE: 4 h, DCE: 2 h) 3. Geophysics: Jobsite (PM: 4 d x 6 h, FE: 2 d x 6 h), Office (PM: 4 h, STA: 4 h, SPE: 2 h, DCE: 2 h) 4. Dam Coring: Jobsite (PM: 2 d x 6 h, SPE: 2 d x 8 h, FE: 2 d x 6 h), Office (PM: 4 h, STA: 4 h, SPE: 2 h, DCE: 2 h) 5. *Office time is for reports review and gathering jobsite info. Page 7 of 17 DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039 Overall Description: Summary By Cost Type QTY Airfare 4 Car Rental and Fuel 4 PM Company Vehicle 4x4 (Apportioned) 1.4 HOURS Hotel/Lodging/Meals 4 Reproduction Cost 4 Fort Collins JV Office Operations&Maintenance (Apportioned) 1.4 DESCRIPTION QTY OT DESCRIPTION HOURS Fort Collins JV Office Rental (Apportioned) 1.4 DESCRIPTION QTY DESCRIPTION QTY Page 6 of 17 DocuSign Envelope ID: 149121AD-F2B4-486A-8209-B0B824C19039