HomeMy WebLinkAboutChange Order No 1 - FLIR Traffic Camera Replacements Proj No 118-006 - Pemberton Davis Electric1316 COUNTY-Crry BuILDING
227 W. JEFFERSON BOULE.VARD
Sount BEND. INDIANA 46601-1830
June 12, 2018
Tanner Leibovitz,
Pemberton Davis Electric, Inc.
9161 McKinley Avenue
Misbawaka, IN 46545
PijoNF 574/235-9251
FAX 574/ 235-9171
RE: Change Order No. I - FLIR Traffic Camera Replacements — Project No. 118-006
Dear Mr. Leibovitz:
The Board of Public Works, at its meeting held on June 12, 2018, approved the above
referenced Change Order for an increase of $13,756, bringing the current contract amount to
$123,866.10.
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,
Linda M. Martin, Clerk
Enclosure
c: Toy Villa, Engineering
Roger Nawrot, Engineering
Derick Robert, Streets
Ed Gleckler, Traffic & Lighting
GAR' A. GILOT SUZANNA M. FRITZBERG Et.,iZABEm A. MARADIK JAMEs A. MUELLER 'nIE'RESE J. DoRAU
CITY OF SOUTH BEND, INDIANA
DEPARTMENT OF PUBLIC WORKS
PROJECT CHANGE ORDER
DATE: 5/26/2018
PROJECT NO: 118-006
PROJECT NAME:
CONTRACT DATE:
CHANGE ORDER NO:
SUBJECT OF CHANGE ORDER:
FUR Traffic Camera Replacements
2/13/2018
I
PCR #1-5 Amp Power Supply,Rack, & SDLC Cable, PCR #2-
Span/Cant/Tether & Remove/Replace Signs Disconnect PCR #3-
Signal Head Remove and _Replace
The original contract sum
Net change by previously authorized change orders
The contract sum prior to thiis 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
Original contracted completion date/time
Extension of date/time by previous change orders
Date/time extension by this change order
New completion date/time
CON -TRACTOR
ContrAtor Sig attire
LV
Printed Name and Title
Pemberton Davis Electric, Inc.
Company Name
916 E. McK inle Ave.
Address
Mishawaka:, IN 46545
City, State, Zip
FX] Increased
[] Decreased
.6/20/20118
0-days
0 days
6/20/2018
110,110.10
0.00
110,110.110
$ 13,756,00
$ 123,86610
12-49 %
12.491 %
I 11i'll ","
CONSTR�U ,rION MANAGER
NMAEWi�LW
NUAM
Gary A. Gilot, President
Suzanna M. Fritzberg, Member
C uLL
Elizabeth A. Maradilk, Member
Therese J. Qlbrau, M—ember
James A. Mueller, Member
DEPARTMENT OF PUBLIC WORKS
DIVISION OF ENGINEERING
PROJECT CONTRUCTION CHECKLIST
Project No.
118-006
NTP
3/12/2018
Project Name
FLIR Traffic Camera Replacements
Sub. Comp.
Contractor
Pemberton Davis Electric, Inc.
Final Comp.
6/20/2018
Inspector
JJE
Today's Date
6/4/2018
PAY APPLICATIONS & CHANGE ORDERS CHART
Pay Ap I)
Contracl EVA
$75,000.00
$50,000.00
$25 1000 00
3/2512018
4/812018 4122/2018 5/612018 512012018
6/3Y2018
6/17120 18
PAYMENITIAPPLI CATION SUMMARY
... .... ....... .. ... . . .. .... -
.. ............
CHANGE
ORDER SUMMARY
Date
Prv. Contract
Change Amt.
New Contract
Change %
Total % _
Added Days
1
5/26/18
$110,110.10
$13,756.00
$123,866.10
12.49%
12.49%
0
2
3
S
$13,756.00
12.49%1
6/2012018
POST -CONSTRUCTION DOCUMENT CHECKLIST
Items
Notes
Date Ree'D
I
Final Pay Application
2
Project Compleflon Affidavit
3
Finai Waiver of Lion
4
Final Chan Order
Complete Certified Pa rolls
6
1 As -Built Documents
7
1 Testing Reports
8
lWarrant y information
Signature: w - Date:
'TN \
BOARD OF PUBLIC WORKS"
AGENDA ITEM REVIEW REQUEST FORM
Date 06/04/2018 Department
Name Toy Villa Division/Bureau
IMMI'm
Engineering
BPW Date 06/12/2018 Phone Extension 5920
Legal Attorney Name:
Controller ❑ Controller review is required for all Contracts $5,000.00 or more and
greater than one year lin length per the City Purchasing Policy
Purchasing ❑
❑ Agreement Amendment
Ll Contract LJ Proposal H Addendum
Professional Services
F] Resolution
F-1 Bid Opening
0 Bid Award ❑ Req. to Advertise El Title Sheet
E] Quote Opening
El Quote Award
Change Order No. 1
❑ C/O & PCA No. F1 PCA
❑ Ease/Encroach.
❑ Traffic Control:
Other:
Company or Vendor Name
New Vendor
MBEANBE Contractor
MBENVBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Amount of
❑
Pemberton Davis Electric, Inc.
El Yes M No El If Yes, Approyed by Purchasing
❑ MBE E] WBE
No 0 Yes Name of Company
FUR Traffic Camera Replacements
118-006
LRSA —Traffic, Signal Maintenance
-
251-0608-431.36-67
Approval of Change Order #1.
[:] Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.
Increase $13,756.00
Decrease
Previous Amount
Current Percent of Change:
New Amount
Total Percent of Change:
$ 110,110.10
12.49%
$ 123,86,6.10
12.49%
Copy Original
F] Roger Nawrot, Assistant City Engineer
F-1 Derick Roberts, Director of Streets & Sewers
M 0 Ed Gleckler, Manager Bureau of Traffic & Lighting