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HomeMy WebLinkAboutWORK ORDER - PURCHASE ORDER - 9180967Utilities Work Order Form Official Purchasing Form Last updated 10/2017 WORK ORDER PURSUANT TO A MASTER AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND AYRES Associates WORK ORDER NUMBER: MC Planning-AYRES-01-2018 PROJECT TITLE: Mail Creek Rehab at Meadow Passway ORIGINAL BID/RFP NUMBER & NAME: 8073 ENGINEERING SERVICES FOR WATER,WASTEWATER & STORMWATER FACILITIES CAPITAL IMPROVEMENTS PROJECTS MASTER AGREEMENT EFFECTIVE DATE: 5/15/15 ARCHITECT/ENGINEER: OWNER’S REPRESENTATIVE: Jason Stutzman WORK ORDER COMMENCEMENT DATE: January 2018 WORK ORDER COMPLETION DATE: April 2018 MAXIMUM FEE: (time and reimbursable direct costs): $15,640 PROJECT DESCRIPTION/SCOPE OF SERVICES: See Attached 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 Seven (7) 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: AYRES Associates By: Date: Name: Title: DocuSign Envelope ID: DC779748-1629-41F4-8B4D-391266AE0668 Jjohn Hunt Manager-River Engineering 1/26/2018 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: Jason Stutzman, Project Manager 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, Chief Engineer ACCEPTANCE: Date: Matt Fater, Intrm Wtr Eng Fld Svcs Op Mgr 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) DocuSign Envelope ID: DC779748-1629-41F4-8B4D-391266AE0668 N/A N/A 1/26/2018 N/A N/A N/A 1/28/2018 1/30/2018 1/30/2018 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT A WORK ORDER SCOPE OF SERVICES DocuSign Envelope ID: DC779748-1629-41F4-8B4D-391266AE0668 January 2, 2018 1 MAIL CREEK PLANNING PROJECT OBJECTIVE: Planning to determine scope and features of Mail Creek stream rehabilitation project. GENERAL Ayres will prepare for, and attend, team and public meetings. The following Scope of Services outlines the planning tasks. 1 Task 1 – Administrative 1.1 Management – This task covers general project management, contracting, invoicing, internal coordination. 1.2 Team meetings (8) - Team planning meetings will be held as needed to prepare for the public meetings. These meetings may also include Potentially Affected Individuals (PAIs). Time for this task includes meeting preparation, creation of exhibits, and attending meetings. A total of 8 meetings are included in this scope. 1.3 Public meetings (2) – Two public meetings are planned to inform the primary landowners and secondarily the public near the project area. Time for this task includes meeting preparation, creation of exhibits, and attending meetings. A total of 2 meetings are included in this scope. SUMMARY OF PROJECT DELIVERABLES • Meeting minute summaries as pertains to the stream rehabilitation project • Exhibits created for meetings DocuSign Envelope ID: DC779748-1629-41F4-8B4D-391266AE0668 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT B WORK ORDER COST DETAIL DocuSign Envelope ID: DC779748-1629-41F4-8B4D-391266AE0668 Task # Task Name Total By Task Direct Costs Total Labor Costs Senior Engineer Project Manager Project Engineer CAD/GIS Admin Start Date Plan End Date Plan 1 Fee Proposal Fee Hours 2 Project Name Mail Creek Planning 3 Project Manager Dusty Robinson 4 Client Contact Jason Stutzman 5 Ayres Staff John Hunt Dusty Robinson 6 Rates $175.00 $135.00 $115.00 $95.00 $75.00 7 Project Totals $15,640 $0 $15,640 4 74 16 28 6 01/08/18 04/27/18 8 Task 1 Administrative $15,640 $0 $15,640 4 74 16 28 6 01/08/18 04/27/18 9 1.1 Management $3,500 $3,500 2 20 6 01/08/18 04/27/18 10 1.2 Team meetings (8) $7,840 $7,840 40 8 16 01/08/18 04/13/18 11 1.3 Public meetings (2) $4,300 $4,300 2 14 8 12 01/26/18 03/08/18 Exported on January 2, 2018 12:58:27 PM MST DocuSign Envelope ID: DC779748-1629-41F4-8B4D-391266AE0668 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. DocuSign Envelope ID: DC779748-1629-41F4-8B4D-391266AE0668 The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) AUTHORIZED REPRESENTATIVE CANCELLATION CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) JECT LOC POLICY PRO- GEN'L AGGREGATE LIMIT APPLIES PER: CLAIMS-MADE OCCUR COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ DED RETENTION $ CLAIMS-MADE OCCUR $ AGGREGATE $ UMBRELLA LIAB EACH OCCURRENCE $ EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS PER STATUTE OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED HIRED NON-OWNED AUTOS ONLY AUTOS AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: 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 rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: INSURED PHONE (A/C, No, Ext): PRODUCER ADDRESS: E-MAIL FAX (A/C, No): CONTACT NAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1/26/2018 Arthur J. Gallagher Risk Management Services, Inc. 245 South Executive Drive, Suite 200 Brookfield WI 53005 AYRES ASSOCIATES INC 3433 Oakwood Hills Parkway Eau Claire, WI 54702-1509 Travelers Property Casualty Co of America The Travelers Indemnity Company of CT 25674 25682 Sharon Bannach 262-792-2214 262-792-1712 Sharon_Bannach@ajg.com AYREASS-02 751709312 A P6302183P260TIA18 1/1/2018 1/1/2019 1,000,000 100,000 10,000 1,000,000 2,000,000 2,000,000 X X X X A X X X P8103790P125TIL18 1/1/2018 1/1/2019 1,000,000 A X X X 0 CUP9J784097-18-43 1/1/2018 1/1/2019 7,000,000 7,000,000 cts/Comp Ops Agg 7,000,000 B N UB9H943775018 1/1/2018 1/1/2019 X 1,000,000 1,000,000 1,000,000 RE: Mail Creek Rehab at Meadow Passway | BID #: 7445 The City of Fort Collins Utilities Fort Collins CO 80522 DocuSign Envelope ID: DC779748-1629-41F4-8B4D-391266AE0668