HomeMy WebLinkAboutAmendment to Agreement - Dale Clingerman1316 COUNTY -CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOUTH BEND. INDIANA 46601-1930
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
November 8, 2016
Dale Clingerman
1312 Carriage Court, Apt. D
LaPorte, IN 46350
PHONE 574/235-9251
FAx 574/235-9171
RE: Amendment to Agreement — Third Amendment to Independent Contractor
Agreement for One -Way to Two -Way Inspection Services to Extend the Term from October
29, 2016 to November 30, 2016
Dear Mr. Clingerman:
The Board of Public Works, at its meeting held on November 8, 2016, approved the above
referenced amendment to your Independent Contractor 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
Michael Divita, Community Investment
GARY A. GILOT SUZANNA M. FRITZBERG ELIZABETH A. MARADIK JAMES A. MUELLER THERESE J. DORAU
THIRD AMENDMENT TO
INDEPENDENT CONTRACTOR AGREEMENT
BY AND BETWEEN THE CITY OF SOUTH BEND, INDIANA,
AND DALE CLINGERMAN
THIS THIRD AMENDMENT TO THE ONE WAY Tq �T1[V,,0 WAY �S�T�R�E��E�TSC��O,N��VERSION INSPECTION
SERVICES AGREEMENT, is entered into on this day of , 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 the Second
amendment to the original agreement made effective September 27, 2016.
WHEREAS, this agreement is entered into as the Third 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, of the Agreement, shall be and is
hereby amended and replaced as follows to modify the type of liability insurance
coverage required:
(1) Amend Sub Paragraph 4 of the Original Agreement by changing the word
"Professional" in the second line to "General Commercial." Such change to be
effective on November 2, 2016.
(2) Amend Sub Paragraph 6 of the Original Agreement, as previously amended by the
Second Amendment to the Agreement by extending the date of completion of the
Agreement to be not later than December 2, 2016.
(3) Each and every other provision of the Original Agreement, the First Amendment and
Second 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, the First Amendment and Second Amendment to same are not affected
by this Third Amendment and shall remain in full force and effect.
(4) This Second Amendment may be executed in multiple counterparts, each of which
shall be deemed and original
(5) The terms of this Third amendment to the Agreement shall be retroactive to be
effective on October 29, 2016, and thereafter until termination.
(6) 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)
Jc, &t- 27,'LUl6
(Date)
CITY OF SOUTH BEND, INDIANA
"'PROVED
'SUtrd Of P blir
WfAF
(Signature)
NOV 06. 16
ILA
(Date) _
(Printed•'ia=-e.ppd Title
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 10/31/16
Name Toy Villa Department Engineering
BPW Date 11/08/16 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 El
Check the Appropriate Item Type — Required for All Submissions
❑
❑
Agreement
Professional Services
❑ Contract ❑Pro osal
p ❑Addendum
❑ Resolution
❑
❑
Bid Opening
Quote Opening
❑ Bid Award ❑ Re to Advertise
❑ Quote Award q' Title Sheet
❑
Change Order No.
❑ C/O & PCA No. ❑ PCA
❑
Ease/Encroach.
❑ Traffic Control
�q
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
mequirea information
MDale Clin erman
Yes No ❑ If Yes
❑ MBE ❑ WBE
❑ No ❑ Yes Name of Com
One Way to Two Way Conver
116-001
TIF Bond
Amend the original contract by extending the tern of the contract from
October 29, 2016, to November 30, 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
MIR
For Chanqe Orders
Dispersal After