HomeMy WebLinkAboutChange Order No 3 & PCA - Three Twenty at the Cascade Site Utilities Proj No. 118-074D - Indiana Earth, Inc.1316 COUNTY -CITY BUILDING
227 W.JEFFERSON BOULEVARD
SOUTH BEND, INDIANA 46601-1830
CITY OF SOUTH BEND JAMES MUELLER, MAYOR
BOARD OF PUBLIC WORKS
July 28, 2020
Mr. Mark Osler
Indiana Earth, Inc.
10343 McKinley Hwy.
Osceola, IN 46561
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PHONE 574/235-9251
FAX 574/ 235-9171
RE: Change Order No. 3 (Final) and Project Completion Affidavit —Three Twenty at the
Cascade — Site Utilities - Project No. 118-074D (Division A&C)
Dear Mr. Osler:
The Board of Public Works, at its meeting held on July 28, 2020, approved the final Change
Order No. 3 in the amount of $6,039,50 and the Project Completion Affidavit for this project
in the amount of $195,222.50.
A copy of the Change Order and the Project Completion Affidavit is enclosed for your records.
If you have any further questions regarding this matter, please call this office at (574) 235-
9251.
Sincerely,
s/Linda M. Martin, Clerk
Enclosure
GARY A. GILOT ELIZABETH A. MARADIK THERESE J. DORAU JORDAN V. GATHERS JOSEPH R. MOLNAR
Project Number: 118-074D
DEPARTMENT OF PUBLIC WORKS
DIVISION OF ENGINEERING
Three Twenty at the Cascade - Site Utilities (Div. A & C) 3
Project Name: Change Order #: —
DATE INITIATED: 6-15-20 BPW DATE: 7-14-20
Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.).
Soil was uncovered that was suspected to be contaminated. Testing was completed and came
back negative. An additional catch basin was added to alleviate a noxious smell from a drywell
area.
Attachments: (List documents support change — required)
Soil Testing: Add $313.50
Add Catch Basin: Add $2,100.00
Remove and Replace Rubble: Add $2,857.00
Final Quantity Adjustment: Add $769.00
Amount of DIncrease/ ❑Decrease: $ 6,039.50
Previously approved Change Order(s): $ 20,71 1.00
Current Percent of Change: 3.19
New Total Amount: $ 195,222.50
Total Percent of Change: 15.88
Funding Secured From: 429-10-102-121-442001
(filled out by PM)
RECOMMENDED BY:
Dan Jones
Project Inspector (Print Name)
REVIEWED BY:
Toy Villa
Construction Manager (Print Name)
APPROVED BY:
Zach Hurst
Engineering Project Manager (Print Name)
APPROVED BY:
Kara Boyles
City Engineer (Print Name)
Categories (Pick One):
❑ Scope of Work
0 Differing Site Conditions, Changed Conditions
❑ Conflicted Specifications and Drawings
❑ Failed Materials
❑ Error
❑ Omission
0 Final Quantity Adjustment
El
Daniel Jones
Dlgilally signed by Daniel Jones
DN'. jDaniel Jones.. o=City of 5oulM1 Bend, IN Engineering,
wPro�ecl Inspector. email�fones�gsoulbbendin_gw, .-US
Dale 2g 0.g4 g615.15:29-04'gg'
6-22-20
(Signature)
(Date)
Toy Villa
Digitally signed by Toy Villa
6�22�2020
Date: 2020.06.22 20:14:58-04'00'
(Signature)
(Date)
Zachary Hurst
91alNsindby drz b, �E bb.d,NB�lale
,ery1,,r=' o,BaurbBnnd o
DD 21nenl of Publlo Works. ertiaikzM1urst[}sou0rbandhi.gov. WSJ
e - aa-0a'o9
6/24/2020
(Signature)
(Date)
Kara Boyles
Digitally signed by Kara Bayles
7�21 �2020
Date: 2020.07.21 12:31:00-04'00'
(Signature)
(Date)
CITY OF SOUTH BEND, INDIANA
DEPARTMENT OF PUBLIC WORKS
PROJECT CHANGE ORDER
DATE: 7/7/2020
PROJECT NO:
PROJECT NAME:
CONTRACT DATE:
118-074D (Division A&C)
Three Twenty at the Cascade - Site Utilities
12/20/2018
CHANGE ORDER NO: 3 (Final)
SUBJECT OF CHANGE ORDER: PCR #9-Soil Testing T&M PCR #10-Add CB PCR #11-Remove and
Replace Rubble PCR #12-Final Quantities
All items completed substantially as planned.
See attached Comparison of Estimate for overruns and underruns.
The original contract sum $ 168,472.00
Net change by previously authorized change orders $ 20,711.00
The contract sum prior to this change order $ 189,183.00
By this Change Order, the project amount is 0 Increased
Decreased $ 6,039.50
The new contract sum including this change order $ 195,222.50
This Change Order represents a total change of 3.19 %
Total change for entire project 15.88 %
Original contracted completion date/time
Extension of date/time by previous change orders
Date/time extension by this change order
New completion date/time
�NTOR
Contractor Sghature
Printed Name and Title
Indiana Earth, Inc.
Company Name
10343 McKinley Highway
Address
6/14/2019
0 days
0 days
6/14/2019
RECOMMENDED FOR APPROVAL
CONSTRUCTION MANAGER
CITY OF SOUTH BEND
BOARD OF PUBLIC WORKS
Approved Date: July 28, 2020
BOARD OF PUBLIC WORKS
Osceola, IN 46561 Gary A.Gilot,President
Therese J.Doma,Member
City, State, Zip
Elizabeth A. Maradik, Member
Jordan V. Gathers. Member
7Y
ATTEST:
�'-m z clt nns,
Joseph R. Molnar, Member
Linda M. Martin. Clerk
PROJECT NAME
PROJECT NO
CONTRACT SIGNED
PROJECT DESCRIPTION
WITNESSETH:
Y JJI11 R/cdjJ,
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS77
PROJECT COMPLETION AFFIDAVIT
Three Twentv at the Cascade - Site Utilities
118-074D (Division A&C) FINAL COST $195,222.50
12/20/2018 MAINTENANCE AGREEMENT ENDS
Installation of water main and storm sewer.
The work under the above contract between the City of South Bend and the undersigned contractor having been completed,
the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever arising under or
by such contract, and that the contractor performed the work within the scope of the Specifications and Standards of the City
of South Bend which\uypre a part of the above Contract.
Executed th' day of s'" . �` 20='' Indiana Earth, Inc.
Company Name
gnature /7 10343 McKinley Highway
too�& 05 Lei- re-(( ` Company Address
Printed Name Osceola, IN 46561
City, State, Zip
WITNESSESS:
Before me, the undersigned Notary Public in and for said country and state, personally appeared
0 vt and acknowledged his/her signature to the above Project Completion Affidavit on
the day of J r-�`— 20$ Amanda Lynette Johnson
n FNotary Public Seal State of Indiana
St. Joseph County
Commission Number NP0725748
NotarySignature My Commission Expires Commission Expires03110/2028
Printed Name County of Residence
If the Contractor is a corporation, the following certificate will be executed.
I, (M certify that I am Secretary of the Corporation executing this release; that
who signed this release on behalf of the contractor was then
/��'SdOCiT of said Corporation; that said release was duly signed for and on behalf of said
Corpo tivyfiozritro�ts e ning body,,andis within the scope of corporate powers:
77t „�
Secretary's Signature
Corporate Seal
Printed Name
DEPARTMENT OF PUBLIC WORKS APPROVAL
This project is acceptable for final approval and we recommend to the Board of Public Works that it be ordained so.
Date: 07/16/2020
ConstructOn Manager
BOARD OF PUBIAC W QRKS
Clary A. Gilot, President
Elizabeth A. Maradik, Member
Joseph R. Molnar, Member
BOARD OF PUBLIC WORKS APPROVAL Date: July 28, 2020
Therese J. Domia, Mein
Tordan V. Gathers, Member
Allr r:
o ia:;fu CPfnns
I i,,6 M. Martin_ Clerk
Final Waiver of Lien
State of Indiana, County of r\ SS: La f L L LN /� being duly sworn that he/she is the _ 1 eS� C� n I
L
(Name of Officer) (Title)
of TCtA"Ar'r' C—CLA� Tn�. having contracted with City of South Bend
(Contractor) (owner)
to furnish certain materials and/or labor as follows;
for a project known as -T h f -e f-
,_)res
located at 6 G CC) l C ,�,l_dx�in fStr 1 I�
and owned by City of South Bend
_._._ (owner)
and does hereby further state on the behalf of the aforementioned subcontractor/supplier:
(PARTIAL WAIVER) that there is due from the Contractor the sum of
Dollars ($ )
❑ receipt of which is hereby acluiowledged; or
❑ the payment of which has been promised as the sole consideration for this Affidavit and. Final Waiver of Lien -which is given
solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the
undersigned;
FINAL WAIVER) that the final balance due from the contractor is the sum of
❑ receipt of which is hereby acknowledged; or
® the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall
become effective only uponreceipt of such payment.
THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all liens or claims whatsoever
on the above -described property and improvements thereon an account of labor or material or both„ furnished b the undersigned
thereto, subj ect to limitations or conditions expressed herein, if any; and further certified that no other party has any claim or right to a
lien on account of any work performed or material furnished to the undersigned for said project, and within the pe of this Affidavit
and Waiver ofLien. P" ,, —'
Dy
utn (Autho 'zedRepres dative)
STATE OF 1NDIANA ) ) Wit U SlQ r, � (Q
SS:
ST. IOSEPH COUNTY )
Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared kxo-rL
and acknowledged the execution of the foregoing Affidavit and Waiver of Lien.
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal on the S'7 day of
Notary Publie Signature
My Commission Expires: 3 1 (d 1?yZ�
Residing in 2-e h County, TryL ang\ Notary Public Name
Amanda Lynette Johnson
Notary Public Seal State of Indiana
St. Joseph County
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 07/21/2020
Name Zach Hurst Department DPW
BPW Date 07/28/2020 Phone Extension 3057
Review and Approval Required Prior to Submittal to Board
Diversity Compliance
and Inclusion Officer ❑ Officer Name
BPW Attorney ❑ Attorney Name
Dept. Attorney ❑ Attorney Name
Purchasing ❑
Check the Appropriate Item Type — Re uired or All Submissions
❑ Professional Services Agreement ❑ Contract ❑ Proposal
❑ Open Market Contract ❑ Amendment/Addendum ❑ Special Purchase, QPA
❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet
❑ Quote Opening ❑ Quote Award ❑ Reject Bids/Quotes
❑ Proposal Opening ❑ C/O & PCA No. ❑ PCA
® Chg. Order, No. 3 ❑ Traffic Control ❑ Resolution
n Other: n Ease./Encroach
Information
Company or Vendor Name
Indiana Earth, Inc.
❑ Yes ❑ If Yes, Approved by Purchasing
New Vendor
® No
MBE Yes
MBE/WBE Contractor
Completed E-Verify Form Attached
❑ ❑ No
Project Name
320 at the Cascade — Site Utilities
Project Number
118-074D
Funding Source
River East TIF
Account No.
429-10-102-121-442001
Amount
$6,039.50
Terms of Contract
Purpose/Description
Change order covering unforeseen conditions — contaminated soil.
For Change Orders Only
Amount of ® Increase $ 6,039.50
❑ Decrease ($ )
Previous Amount
$ 189,183.00
Increase
Current Percent of Change:
Decrease
New Amount
$ 195,222.50
Increase
Total Percent of Change:
Decrease
Time Extension Amount:
New Combletion Date:
3.19%
15.88%
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 07/17/2020
Department
Name Toy Villa Engineering
BPW Date 07/28/2020 Phone Extension 5920
Review and Approval Required Prior to Submittal to Board
Diversity Compliance
and Inclusion Officer ❑ Officer Name
BPW Attorney ❑ Attorney Name
Dept. Attorney ❑ Attorney Name
Purchasing
❑�
Check the Appropriate Item Type — Required for All Submissions
❑ Professional Services Agreement ❑ Contract ❑ Proposal
❑ Open Market Contract ❑ Amendment/Addendum ❑ Special Purchase, QPA
❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title
Sheet
❑ Quote Opening ❑ Quote Award ❑ Reject Bids/Quotes
❑ Proposal Opening ❑ C/O & PCA No. ® PCA
❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution
❑ Other: ❑ Ease./Encroach
Required Information
Company or Vendor Name
New Vendor
MBE/WBE Contractor
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Indiana Earth, Inc
❑ Yes ❑ If Yes, Approved by Purchasing
❑ No
❑ WBE Completed E-Verify Form Attached Yes
❑ No
320 at the Cascade — Site Utilities
118-047D
River East TIF
429.1050.460.42.02
$195,222.50
Project Closeout
For Change Orders Only
Amount of ❑ Increase $
❑ Decrease ($ )
Previous Amount $
Increase
%
Current Percent of Change:
Decrease
%
New Amount
$
Increase
%
Total Percent of Change:
Decrease
%
Time Extension Amount: