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HomeMy WebLinkAboutWORK ORDER - RFP - 8073 ENGINEERING SERVICES FOR WATER, WASTEWATER, & STORMWATER FACILITIES CAPITAL IMPROVEMENTS PROJECTS (2)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 ANDERSON CONSULTING ENGINEERS, INC. WORK ORDER NUMBER: Mag-ACE-2 PROJECT TITLE: Magnolia Street Outfall-Alternative Analysis ORIGINAL BID/RFP NUMBER & NAME: 8073, Engineering Services for Water, WW and Stormwater Facilities Capital Improvements MASTER AGREEMENT EFFECTIVE DATE: May 15, 2015 ARCHITECT/ENGINEER: Anderson Consulting Engineers, Inc. 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): $80,822.00 PROJECT DESCRIPTION/SCOPE OF SERVICES: Magnolia Street Stormwater Outfall Project Identification and feasibility evaluation. The prime consultant will be Anderson Consulting that will conduct and manage the alternative identification and feasibility evaluation. Input pertaining the geotechnical engineering services required for this scope of work will be provided by Lithos Engineering. 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 nine (9) 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: Anderson Consulting Engineers, Inc. By: Date: Name: Title: Page 1 of 13 DocuSign Envelope ID: CBCF4A9C-A7A3-4741-ACC5-F4DD3D79C510 Bradley A. Anderson March 8, 2018 President 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 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 13 DocuSign Envelope ID: CBCF4A9C-A7A3-4741-ACC5-F4DD3D79C510 March 7, 2018 March 7, 2018 March 8, 2018 March 9, 2018 March 9, 2018 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT A WORK ORDER SCOPE OF SERVICES & COST DETAIL Page 3 of 13 DocuSign Envelope ID: CBCF4A9C-A7A3-4741-ACC5-F4DD3D79C510 Page 4 of 13 DocuSign Envelope ID: CBCF4A9C-A7A3-4741-ACC5-F4DD3D79C510 Page 5 of 13 DocuSign Envelope ID: CBCF4A9C-A7A3-4741-ACC5-F4DD3D79C510 Page 6 of 13 DocuSign Envelope ID: CBCF4A9C-A7A3-4741-ACC5-F4DD3D79C510 Page 7 of 13 DocuSign Envelope ID: CBCF4A9C-A7A3-4741-ACC5-F4DD3D79C510 Page 8 of 13 DocuSign Envelope ID: CBCF4A9C-A7A3-4741-ACC5-F4DD3D79C510 Page 9 of 13 DocuSign Envelope ID: CBCF4A9C-A7A3-4741-ACC5-F4DD3D79C510 Page 10 of 13 DocuSign Envelope ID: CBCF4A9C-A7A3-4741-ACC5-F4DD3D79C510 Page 11 of 13 DocuSign Envelope ID: CBCF4A9C-A7A3-4741-ACC5-F4DD3D79C510 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 13 of 13 DocuSign Envelope ID: CBCF4A9C-A7A3-4741-ACC5-F4DD3D79C510 CERTIFICATE.OF.LIABILITY.INSURANCE DIB DATE (MM/DD/YYYY) R004 12/9/2017 THIS CERTIFICATEIS 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). PRODUCER CONTACT NAME: USI COLORADO LLC/PHS PHONE (A/C, No, Ext): (866) 467-8730 FAX (A/C, No): (888) 443-6112 341438 P:(866) 467-8730 F:(888) 443-6112 E-MAIL ADDRESS: PO BOX 33015 INSURER(S) AFFORDING COVERAGE NAIC# SAN ANTONIO TX 78265 INSURER A : Hartford Casualty Ins Co 29424 INSURED INSURER B : INSURER C : ANDERSON CONSULTING ENGINEERS, INC. INSURER D : 375 E HORSETOOTH RD BLDG 5 INSURER E : FORT COLLINS CO 80525 INSURER F : 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR 34 SBW KC5665 DAMAGE TO RENTED PREMISES (Ea occurrence) $300,000 A X General Liab X 12/28/2017 12/28/2018 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X PRO- JECT LOC PRODUCTS - COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $1,000,000 ANY AUTO 34 SBW KC5665 BODILY INJURY (Per person) $ A OWNED AUTOS ONLY 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? DocuSign Envelope ID: CBCF4A9C-A7A3-4741-ACC5-F4DD3D79C510 (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 1/17/2018 Hall & Company 19660 10th Ave NE Poulsbo WA 98370 Jim Ledbetter 360-626-2019 360-598-3703 jledbetter@hallandcompany.com NAVIGATORS INSURANCE COMPANY 42307 739 Anderson Consulting Engineers Inc 375 E Horsetooth Rd, Bldg 5 Fort Collins CO 80525 1551539299 A Professional Liab;Claims Made CM18DPL022684IV 2/11/2018 2/11/2019 $2,000,000 Per Claim $3,000,000 Aggregate Additional Insured Status is not available on Professional Liability Policy. Project: RFP 8073 Engineering Services for Future Water, Wastewater & Stormwater Facilities CIP City of Fort Collins PO Box 580 Fort Collins CO 80522-0580 DocuSign Envelope ID: CBCF4A9C-A7A3-4741-ACC5-F4DD3D79C510 SCHEDULED AUTOS X 12/28/2017 12/28/2018 BODILY INJURY (Per accident) $ X HIRED AUTOS ONLY X NON-OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) $ $ X UMBRELLA LIAB X OCCUR 34 SBW KC5665 EACH OCCURRENCE $8,000,000 A EXCESS LIAB CLAIMS-MADE 12/28/2017 12/28/2018 AGGREGATE $8,000,000 DED X RETENTION $ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N/ A PER STATUTE OTH- ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) Y/N E.L. EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. RFP 8073 Engineering Services for Future Water, Wastewater & Stormwater facilities CIP CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins PO BOX 580 FORT COLLINS, CO 80522 AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: CBCF4A9C-A7A3-4741-ACC5-F4DD3D79C510