HomeMy WebLinkAboutAmendment to PSA - Dale Clingerman (2)1316 COUNTY -CITY BUILDING
227 W. JEFFERSON BOULEVARD
So117'H BEND. INDIANA 46601-1830
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
September 27, 2016
Mr. Dale Clingerman
1312 Carriage Ct.
Apt. D
LaPorte, IN 46350
PHONE 574/235-9251
FAx 574/235-9171
RE: Amendment to Professional Services Agreement — Extend the Term of the
Agreement from September 16, 2016 through October 29, 2016 for Inspection
Services for One -Way to Two -Way Conversion
Dear Mr. Clingerman:
The Board of Public Works, at its meeting held on September 27, 2016, approved the above
referenced agreement.
Enclosed please find a copy of the agreement for your records.
If you have any further questions regarding this matter, please call this office at (574) 235-
9251.
Sincerely,
Linda M. Martin, Clerk
Enclosure
c: Toy Villa, Engineering
GARY A. GILOT DAVID P. RELOS ELIZABETH A. MARADIK JAMES A. MUELLER THERESE J. DORAU
SECOND AMENDMENT TO
INDEPENDENT CONTRACTOR AGREEMENT
BY AND BETWEEN THE CITY OF SOUTH BEND, INDIANA,
AND DALE CLINGERMAN
THIS SECOND AMENDMENT TO THE ONE WAY TO TWO WAY STREETS CONVERSION
INSPECTION SERVICES AGREEMENT, is entered into on this 201^ day of September, 2016, by the
City of South Bend, Indiana, a municipal corporation organized and operating under the laws of
the State of Indiana, acting by and through its Board of Public Works, and having its offices at
1216 County -City Building, 227 West Jefferson Boulevard, South Bend, Indiana 46601 ("City")
and Dale Clingerman, 1312 Carriage Ct., Apt D., La Porte, Indiana 46350 ("Independent
Contractor").
WHEREAS, City and Independent Contractor are parties to an Agreement entitled "Independent
Contractor Agreement' made effective April 26, 2016 ("Agreement"); and the First
Amendment to the original agreement made effective September 13, 2016; and
WHEREAS, this agreement is entered into as the Second Amendment to Agreement to modify
certain terms and conditions expressed in the Agreement; and
NOW, THEREFORE, in consideration of the mutual promises and obligations set forth herein,
the parties make this Second Amendment to Agreement, as follows:
SECTION 2. Consideration and Terms of Payment, Sub paragraph 6 of the Agreement,
shall be and is hereby amended and replaced as follows to increase the time of
performance of the work:
(1) Amend the original contract by extending the term of the contract from the original
September 16, 2016, to and including October 29, 2016. Such extension of time shall
be retroactive to the original date of September 16, 2016.
(2) Each and every other provision of the Original Agreement and the First Amendment
to that Agreement are hereby ratified and reaffirmed by the parties and all other
matters previously agreed to and set forth in the original Agreement and First
Amendment to same are not affected by this Second Amendment and shall remain
in full force and effect.
(3) This Second Amendment may be executed in multiple counterparts, each of which
shall be deemed and original.
(4) The undersigned person(s) executing and delivering this Second Amendment on
behalf of the Contractor represent and certify that:
a. He/She is the duly authorized agent, representative, member, or officer of the
Contractor and has been fully empowered to execute and deliver this Second
Amendment and that all necessary Corporate action has been taken and done:
and
b. To the best of his/her knowledge, he/she has not, nor has any other member,
employee, representative, agent of office of the Contractor, entered into or
offered to
enter into any combination, collusion, or agreement to receive or pay, and that
he/she has not received or paid, any sum of money other than that which
appears on the face hereof.
IN WITNESS WHEREOF, the Parties hereto have caused this Second Amendment to be executed
as of the day and year first written above.
DALE CLINGERMAN
(Signature)
L
�7c�NN+GY Z Sj 2,01,6
(Date)
CITY OF SOUTH BEND, INDIANA
(Signature) 4PPR
Bow O �ub8orko
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 09/20/16
Name
Toy Villa
Department
Engineering
BPW Date
09/27/16
Phone Extension
5920
Required Prior to Submittal to Board
Legal ® Attorney Name Michael Schmidt
Controller ❑ Controller review is required for all Contracts $5,000.00 or more and
greater than one year in length per the City Purchasing Policy
Purchasing ❑
Check the Appropriate Item Type — Required for All Submissions
❑ Agreement ❑ Contract ❑ Proposal ❑ Addendum
❑ Professional Services ❑ Resolution
❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet
❑ Quote Opening ❑ Quote Award
❑ Change Order No. ❑ C/O & PCA No. ❑ PCA
❑ Ease/Encroach. ❑ Traffic Control
® Other: Amendment
Company or Vendor Name
New Vendor
MBE/WBE Contractor
MBE/WBE Contractor
Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Amount of
Required Information
Dale Clin erman
❑ Yes ® No If Yes, Approved by Pu
MBE r I WBE
LJ No ❑ Yes Name of Company
One Way to Two Way Conversion
TIF
Amend the original contract by extending the term of the contract from the
original September 16, 2016, to and including October 29, 2016.
❑ Required Contractor's Certification Form Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
Increase
Decrease
Previous Amount
Current Percent of Change:
New Amount
Total Percent of Change:
Copy
Original
®
❑
®
❑
❑
❑
Michael Divita
Toy Villa
ired For Chanae Orders
Dispersal After