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Home My WebLink AboutWORK ORDER - PURCHASE ORDER - 9181592Utilities Work Order Form Official Purchasing Form Last updated 10/2017 WORK ORDER PURSUANT TO A MASTER AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND GARNEY CONSTRUCTION WORK ORDER NUMBER: Mag-Garney-2 PROJECT TITLE: Magnolia Street Outfall-Alternative Analysis ORIGINAL BID/RFP NUMBER & NAME: 8016, Utility Infrastructure Construction Services for Water, Wastewater and Stormwater Facilities Capital Improvements MASTER AGREEMENT EFFECTIVE DATE: August 17, 2015 ARCHITECT/ENGINEER: Anderson OWNER’S REPRESENTATIVE: Linsey Chalfant WORK ORDER COMMENCEMENT DATE: March 5, 2018 WORK ORDER COMPLETION DATE: August 30, 2018 MAXIMUM FEE: (time and reimbursable direct costs): $9,975.00 PROJECT DESCRIPTION/SCOPE OF SERVICES: Design assistance for the Magnolia Street Outfall, per the design schedule that defines the design meetings and tasks. 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 three (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: Garney Construction By: Date: Name: Title: Page 1 of 8 DocuSign Envelope ID: FA4DDB05-5B7E-4548-B67A-7E129A77B8AB Gary Haas Project Manager March 5, 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: Linsey Chalfant, Special 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, Water Systems Engineering Division Manager ACCEPTANCE: Date: Matt Fater, Water Engineering & Field Services Operations Interim Manager 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 8 DocuSign Envelope ID: FA4DDB05-5B7E-4548-B67A-7E129A77B8AB March 1, 2018 March 1, 2018 March 5, 2018 March 5, 2018 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT A WORK ORDER COST OF SERVICES Page 3 of 8 DocuSign Envelope ID: FA4DDB05-5B7E-4548-B67A-7E129A77B8AB 7911 Shaffer Parkway, Littleton, CO 80127 Phone: 303.791.3600 Fax: 303.791.1801 www.garney.com February 26, 2018 Ms. Linsey Chalfant Mr. Matt Fater City of Fort Collins Utilities P.O. Box 580 700 Wood Street Fort Collins, CO 80522-0580 RE: Magnolia Street Outfall Design Assistance Proposal Dear Linsey & Matt, We are pleased to offer our design assistance proposal for the Magnolia Street Outfall. Attached is a fee schedule which is based on attending and following up on design meetings and providing three budget level estimate revisions in the first half of 2018. Also attached is a design schedule that defines the design meetings and estimating tasks. We look forward to working with you on this exciting and challenging project. If you have any questions or concerns, please contact me at (970) 222-4124 or ghaas@garney.com. Sincerely, GARNEY COMPANIES, INC. Gary Haas Project Manager Page 4 of 8 DocuSign Envelope ID: FA4DDB05-5B7E-4548-B67A-7E129A77B8AB Magnolia Street Outfall Design Assistance Proposal 02/26/18 Dates Description Gary Haas Pickup Pickup Vehicle Total 02/21/18 Scoping Meeting 2 2 - - - - $ 210 03/29/18 Prepare/Attend/Follow-up 4 4 - - - - $ 420 04/12/18 Prepare/Attend/Follow-up 4 4 - - - - $ 420 04/26/18 Prepare/Attend/Follow-up 4 4 - - - - $ 420 05/10/18 Prepare/Attend/Follow-up 4 4 - - - - $ 420 05/24/18 Prepare/Attend/Follow-up 4 4 - - - - $ 420 06/07/18 Prepare/Attend/Follow-up 4 4 - - - - $ 420 06/21/18 Prepare/Attend/Follow-up 4 4 - - - - $ 420 - - - - - - $ - TBD Estimate Revision 20 - - - - - $ 1,820 TBD Estimate Revision 20 - - - - - $ 1,820 TBD Estimate Revision 10 - - - - - $ 910 TBD Scheduling 25 - - - - - $ 2,275 - - - - - - $ - Total Hours 105 30 - - - - Hourly Rate $ 91 $ 14 $ 75 $ 14 $ 49 $ 10 Total Cost $ 9,555 $ 420 $ - $ - $ - $ - $ 9,975 Total Cost for Design Assistance Scope $ 9,975 PM/Estimator Superintendent PE/Estimator Page 5 of 8 DocuSign Envelope ID: FA4DDB05-5B7E-4548-B67A-7E129A77B8AB Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT B WORK ORDER SCHEDULE & SCOPE DETAIL Page 6 of 8 DocuSign Envelope ID: FA4DDB05-5B7E-4548-B67A-7E129A77B8AB Page 7 of 8 DocuSign Envelope ID: FA4DDB05-5B7E-4548-B67A-7E129A77B8AB 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 8 of 8 DocuSign Envelope ID: FA4DDB05-5B7E-4548-B67A-7E129A77B8AB This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies LDI COI 268896 02 11 NM 772 07-10 Personal & Advertising Injury GENERAL LIABILITY NFORMATION ONLY AND CONFERS NO RIGHTS UP INSURANCE POLICY AND DOES NOT AMEND, EXT THIS CERTIFICATE IS ISS This is to Certify that NAME AND ADDRESS OF INSURED is, at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is subject to all their terms, exclusions and Conditions and is not altered by any requirement, term or condition of any contract or other document with respect to which this certificate may be issued. OFFICE PHONE DATE ISSUED TYPE OF POLICY EXP DATE CONTINUOUS EXTENDED POLICY TERM POLICY NUMBER LIMIT OF LIABILITY WORKERS COMPENSATION RETRO DATE OCCURRENCE CLAIMS MADE AUTOMOBILE LIABILITY OWNED NON-OWNED HIRED OTHER ADDITIONAL COMMENTS * If the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date. NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: COVERAGE AFFORDED UNDER WC LAW OF THE FOLLOWING STATES: EMPLOYERS LIABILITY Bodily Injury by Accident Bodily Injury By Disease Bodily Injury By Disease Policy Limit Each Person Each Accident Each Accident—Single Limit Products / Completed Operations Aggregate Other Other Each Person Each Accident or Occurrence Each Accident or Occurrence UED AS A MATTER OF I ON YOU THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT AN END, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. Certificate of Insurance General Aggregate Per Person / Organization B.I. And P.D. Combined Certificate Holder Liberty Mutual Insurance Group AUTHORIZED REPRESENTATIVE POLICY LIMITS ARE NO LESS THAN THOSE LISTED, ALTHOUGH POLICIES MAY INCLUDE ADDITIONAL SUBLIMIT/LIMITS NOT LISTED BELOW. COMMERCIAL Each Occurrence ✓ Stacy Spieker 3/5/2018 Overland Park / 033S 8700 Indian Creek Parkway, Suite 350 Overland Park KS 66210 913-681-1700 Garney Holding Company/Garney Companies Inc./ Grimm Construction Co. Inc./Garney Federal, Inc./ Encore Construction Group, Inc. 1333 NW Vivion Road Kansas City MO 64118-4554 Job: Magnolia Street Outfall Design Assistance City of Fort Collins, Colorado 4316 LaPorte Avenue Fort Collins CO 80522 60 interest may appear, where required by written contract. City of Fort Collins and Anderson Consulting Engineers are additional insured with regards to general liability and automobile liability, as their RE: Job: Magnolia Street Outfall Design Assistance 10/1/2018 TB2-641-426942-727 $4,000,000 ✓ $4,000,000 $2,000,000 $2,000,000 $300,000 Damage to Premises Rented to You $10,000 Medical Expense 10/1/2018 AS2-641-426942-717 $2,000,000 ✓ ✓ ✓ 10/1/2018 WA2-64D-426942-737 AL, AR, AZ, CO, FL, GA, IA, KS, KY, LA, MD, MO, MS, NC, NE, NM, OK, SC, TN, TX, UT, VA, WV WC2-641-437723-907 policy - WI Includes Coverage 3C, Other all other states States Insurance: All States except those listed and the states of ND, OH, WA, and WY. $1,000,000 WC2-641-437723-907 (Wisconsin) $1,000,000 $1,000,000 40673915 | LM_2660 | 10/17-10/18 - All Lines | Linda Bradfish | 3/5/2018 10:48:54 AM (CST) | Page 1 of 1 DocuSign Envelope ID: FA4DDB05-5B7E-4548-B67A-7E129A77B8AB