HomeMy WebLinkAboutChange Order No. 3 (amended) - 2016 Curb & Sidewalk - Premium Concrete1316 COUNTY -CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOUTH BEND. INDIANA 46601-1830
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
November 8, 2016
Jeremy Jankoviak
Premium Concrete
712 Richmond St.
Elkhart, IN 46516
PHONE 574/235-9251
FAX 574i235-9171
RE: Change Order No. 3 (amended) — 2016 Curb and Sidewalk Construction
Project No. 116-029
Dear Mr. Jankoviak:
The Board of Public Works, at its meeting held on November 8, 2016, approved the above
referenced amended Change Order for a decrease of $19,065, bringing the current contract
amount to $400,661.70.
Enclosed is a copy of the Change Order for your records.
If you have any further questions regarding this matter, please call this office at (574) 235-
9251.
Sincerely,
_vim..
Linda M. Martin, Clerk
Enclosure
c: Toy Villa, Engineering
Terri Swift, Streets
GARY A. GILOT SUZANNA M. FRITZBERG ELIZABETH A. MARADIK JAMES A. MUELLER THERESE J. DORAU
CITY OF SOUTH BEND, INDIANA
DEPARTMENT OF PUBLIC WORKS
PROJECT CHANGE ORDER
DATE:
PROJECT NO:
PROJECT NAME:
CONTRACT DATE:
CHANGE ORDER NO:
SUBJECT OF CHANGE ORDER:
SOUTH\bF
F
1665,
10/11/2016
116-029
2016 Curb and Sidewalk Construction
3 - Amended
Adjust curb quantities for Mishawaka
The original contract sum $ 359,750.00
Net change by previously authorized change orders $ 59,976.70
The contract sum prior to this change order $ 419,726.70
By this Change Order, the project amount is
The new contract sum including this change order
This Change Order represents a total change of
Total change for entire project
Original contracted completion date/time
Extension of date/time by previous change orders
Date/time extension by this change order
New completion date/time
CONTRACTOR
VCo r4tfa cto ✓8 ig n atu re
Printed Name and Title
Premium Concrete
Company Name
712 Richmond St
Address
Elkhart, IN 46516
City, State, Zip
LJ Increased
QX Decreased $ 19,065.00
$ 400,661.70
-4.54 %
11.37 %
10/13/2016
7 days
0 days
10/20/2016
RECOMMENDED FOR APPROVAL
CONST U ETION MANAGER
CITY OF SOUTH BEND
BOARD OF PUBLIC WORKS
Approved Date:__ //�-v�9ift,
Gary A. Gil6f President
Fritzberg,
Elizabeth A Maradik, Member
Therese J. Dor u, Member
James A. Mueller, Member
Premium Concrete
Company Name
712 Richmond St
Address
Elkhart, IN 46516
City, State, Zip
CITY OF SOUTH BEND, INDIANA
DEPARTMENT OF PUBLIC WORKS
PROJECT CHANGE ORDER
DATE:
PROJECT NO:
PROJECT NAME:
CONTRACT DATE:
CHANGE ORDER NO:
SUBJECT OF CHANGE ORDER:
The
VVI Ili 0I t pUlll
css
10/1 V2016 0:00:00
116-029 - Div B
2016 Curb and Sidewalk Construction
4/2612016
PCR #1-Remove Curb Islands on Mishawaka Ave from contract
Net change by previously authorized change orders
The contract sum prior to this change order
By this Change Order, the project amount is
The new contract sum including this change order
This Change Order represents a total change of
Total change for entire project
Extension of date/time by previous change orders
Date/time extension by this change order
New completion date/time
CONTRACTOR
c
o act r ignature
Printed Name and Title BOARD OF PUBLIC WORKS
Approved Date: 2p/(0
n� .Z
Gary A. Gilot, President
$
25,575.00
$
0.00
$
Increased
25,575.00
QXDecreased $
19,065.00
$
6,510.00
-74.55
-74.55
%
10/13/2016 0:00:00
0 days
10/13/2016
RECOMMENDED FOR APPROVAL
1
CONST !d TION MANAGER
CITY OF SOUTH BEND
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 10/29/16
Name Toy Villa Department Engineering
BPW Date 11/08/16 Phone Extension 5920
L Kequired Prior to Submittal to Board
Legal ❑ Attorney Name
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 ❑
I
Check the Appropriate Item Type —Required for All Submissions
❑
❑
Agreement
Professional Services
❑ Contract ❑ Proposal ❑ Addendum
❑ Resolution
❑
❑
Bid Opening
Quote Opening
❑ Bid Award ❑ Re to Advertise
El Quote Award q' El Title Sheet
®
Change Order No. 3
❑ C/O & PCA No. ❑ PCA
❑
Ease/Encroach.
❑ Traffic Control
®
Other: Amendment
Required Information
Company or Vendor Name
Premium Concrete
New Vendor
❑ Yes N No ❑ If Yes Approved by Purchasing
MBE/WBE Contractor
❑ MBE ❑ WBE
MBE/WBE Contractor
Requested
❑ No ❑ Yes Name of company
Project Name
2016 Curb and Sidewalk
Project Number
116-029
Funding Source
MVH
Account No.
202.0619.431.31.06
Amount
$
Terms of Contract
Purpose/Description
❑ Required Contractor's Certification Form Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
Amount of
Increase
Previous Amount
Current Percent of Change:
New Amount
Total Percent of Change:
Copy
Original
®
❑
❑
❑
ired For Ch
$ 19,065,
419,726.70
11.37%
Dispersal After Approval
Terri Swift
vma