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WORK ORDER - RFP - 8106 UTILITY INFRASTRUCTURE CONSTRUCTION SERVICES FOR WATER, WASTEWATER AND STORMWATER FACILITIES CAPITAL IMPROVEMENTS
WORK ORDER PURSUANT TO AN AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND Hydro Construction DATED: 08/17/2015 Work Order Number: SCP-WTF-HydroGateLoops-1 Purchase Order Number: Project Title: WTF Replacement – Gate Loops Replacement Original Bid/RFP Number & Name: 8106, Utility Infrastructure Construction Services for Water, Wastewater and Stormwater Facilities Capital Improvements Commencement Date: 09/25/2017 Completion Date: 12/31/2017 Maximum Fee: (time and reimbursable direct costs):$20,591.33 Project Description: Utility Infrastructure Construction Services for Water, Wastewater and Stormwater Facilities Capital Improvements Scope of Services: Services shall include gate loop investigation, removal, installation, and electrical work in association with the access gates located at the Fort Collins Water Treatment Facility Contractor agrees to perform the services identified above and on the attached forms in accordance with the terms and conditions contained herein and in the Construction Work Order Agreement between the parties. In the event of a conflict between or ambiguity in the terms of the Construction Work Order Agreement and this work order (including the attached forms) the Construction Work Order Agreement shall control. The attached forms consisting of ( ) pages are hereby accepted and incorporated herein, by this reference, and Notice to Proceed is hereby given upon full execution of this document. CONTRACTOR Signature: _________________________ By:_______________________________ Title: _____________________________ Date:_____________________________ CITY OF FORT COLLINS Submitted By: _________________________ Sue Paquette, Special Project Manager Date: _________________________ Reviewed by: _________________________ Pat Johnson, Senior Buyer Reviewed by: _________________________ Mark Kempton, Water Production Manger Date: _________________________ Approved by: _________________________ Carol Webb, Water Resources & Treatment Operations Manager Date: ________________________ Approved by: _________________________ Kevin Gertig, Utilities Executive Director (if over $1,000,000) Date: ________________________ Approved by: _________________________ Gerry Paul, Purchasing Director (if over $60,000) Date: _______________________ three 3 NO: 1 PROJECT: FCWTF LOCATION: Fort Collins Water Treatment Plant ITEM: Traffic Detection Loops LABOR $ Subsist Total Employee Hr. Fringe Hours Sub-Total Burden Labor Project Manager $35.00 $0.00 2 $70.00 38% $96.60 Field Engineer $29.00 $0.00 16 $464.00 38% $640.32 Superintendent $35.00 $0.00 8 $280.00 38% $386.40 Operator $31.00 $0.00 0 $0.00 38% $0.00 Craftsmen $28.00 $0.00 12 $336.00 38% $463.68 Laborer $20.00 $0.00 12 $240.00 38% $331.20 Project Coordinator $24.00 $0.00 0 $0.00 38% $0.00 Total This Item $1,918.20 EQUIPMENT (INTERNAL) $ Wk Weeks Sub-Total Repairs Fuel Pick-up $250.00 1 $250.00 $62.50 $137.50 $450.00 Mini - Excavator $621.00 0 $0.00 $0.00 $0.00 $0.00 Bobcat $927.00 0 $0.00 $0.00 $0.00 $0.00 Track Hoe $3,020.00 0 $0.00 $0.00 $0.00 $0.00 Backhoe $1,621.00 0 $0.00 $0.00 $0.00 $0.00 Concrete Saw $375.00 1 $375.00 $0.00 $0.00 $375.00 Confined Space Equip $250.00 0 $0.00 $0.00 $0.00 $0.00 Crane $3,060.00 0 $0.00 $0.00 $0.00 $0.00 Loader $1,800.00 0 $0.00 $0.00 $0.00 $0.00 Small Tools (saw blades, etc.) $57.55 Total This Item $882.55 CONSUMABLE SUPPLIES Misc. $100.00 Total This Item $100.00 PERMANENT MATERIALS Total This Item $0.00 SUBCONTRACTORS & SERVICES Advanced Caulking $650.00 Interstates $15,000.00 Total This Item $15,650.00 INDIRECTS Labor $1,918.20 Equipment $882.55 Consumable Materials $100.00 Permanent Materials $0.00 Subcontractors & Services $15,650.00 Indirects $0.00 Sub-Total Cost $18,550.75 Profit & Overhead $2,040.58 11.0% Profit & Overhead Total of Above: $20,591.33 2 of 4 DocuSign Envelope ID: 86AD5E95-B80F-431E-83B7-BC5F5E575C41 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Project Start Construction Completion Date Substantial Completion Project Schedule 3 of 4 DocuSign Envelope ID: 86AD5E95-B80F-431E-83B7-BC5F5E575C41 The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) 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 ALL OWNED SCHEDULED HIRED AUTOS NON-OWNED AUTOS AUTOS AUTOS 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 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. INS025 (201401) 9/6/2017 Flood and Peterson PO Box 578 Greeley CO 80632 Dana Stewart, CLCS, CIC, CISR (970)266-7149 (970)330-1867 DStewart@floodpeterson.com Hydro Construction Company Inc. 301 E Lincoln Ave Fort Collins CO 80524 Phoenix Insurance Company 25623 Travelers Indemnity Company 25658 Travelers Property Casualty Company 25674 Pinnacol Assurance 41190 Zurich American Insurance Company 16535 CL1733116969 A X X X DTCO8G990899PHX16 4/1/2017 4/1/2018 1,000,000 300,000 10,000 1,000,000 2,000,000 2,000,000 B X X X DT8108G990899IND17 4/1/2017 4/1/2018 1,000,000 C X X X 10,000 DTSMCUP8G990899TIL17 4/1/2017 4/1/2018 5,000,000 5,000,000 D N 2091550 4/1/2017 4/1/2018 X 1,000,000 1,000,000 1,000,000 E Builders Risk PR04012017 4/1/2017 4/1/2018 $15,000,000 Limit E Installation Floater PR04012017 4/1/2017 4/1/2018 $1,000,000 Limit RE: 17-01-475 WTF Replacement-Gate Loops Replacement - Owner's Project #SCP-WTF-HydroGateLoops-1 City of Fort Collins is included as Additional Insured on the General, Automobile, and Umbrella Liability Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. N Mosbrucker CIC,CISR City of Fort Collins 700 Wood Street Fort Collins, CO 80521-1945 4 of 4 DocuSign Envelope ID: 86AD5E95-B80F-431E-83B7-BC5F5E575C41 1 of 4 DocuSign Envelope ID: 86AD5E95-B80F-431E-83B7-BC5F5E575C41 Jim Eurich COO 9/6/2017 9/6/2017 9/7/2017 9/7/2017